Point-of-Care Ultrasound to Estimate Central Venous Pressure

Prekker, Matthew E.; Scott, Nathaniel L.; Hart, Danielle; Sprenkle, Mark D.; Leatherman, James W.

doi:10.1097/ccm.0b013e31827466b7

Cited by 103 publications

(80 citation statements)

References 32 publications

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“…central venous pressure -CVP) and external pressure (intraabdominal pressure -IAP). When IAP is negligible, a linear positive relationship of CVP and IVC diameter is observed (16,17,18). Consequently, "the IVC is the CVP".…”

Section: Ivc Diametermentioning

confidence: 84%

COUNTERPOINT: Should Acute Fluid Resuscitation Be Guided Primarily by Inferior Vena Cava Ultrasound for Patients in Shock? No

Kory

2017

CHEST

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Section: Ivc Diametermentioning

confidence: 84%

COUNTERPOINT: Should Acute Fluid Resuscitation Be Guided Primarily by Inferior Vena Cava Ultrasound for Patients in Shock? No

Kory

2017

CHEST

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“…The IVC may be measured in longitudinal or transverse planes, B or M modes, but there is little evidence to suggest which measurements are most reliably and accurately obtained [5][6][7][8][9][10]. M-mode allows changes in IVC diameter with respiration to be measured in a single screen shot and maximum/minimum values can be obtained easily.…”

Section: Introductionmentioning

confidence: 98%

“…Changes in transabdominal ultrasound measurements of the inferior vena cava (IVC) with respiration or mechanical ventilation, termed the collapse index, have been shown to be a sensitive measure of changes in circulating volume [5,6] and a noninvasive guide to fluid resuscitation [7,8].…”

Section: Introductionmentioning

confidence: 99%

Best approach to measuring the inferior vena cava in spontaneously ventilating patients

Baker

Pott

Khan

et al. 2015

European Journal of Emergency Medicine

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The objective of this study was to establish the reliability of different measurements of inferior vena cava (IVC) size and respiratory variation in response to changes in circulating volume. Transabdominal ultrasound measurements of the IVC were obtained in longitudinal (B and M modes) and transverse planes (B-mode height and ellipse circumference) during inspiration and expiration, and inferior vena cava collapsibility indices (IVCci) were calculated. Measurements were repeated following venesection of ∼450 ml. Thirty patients underwent venesection. Their IVCci increased significantly for transverse and longitudinal height measurements following venesection, but not for transverse circumference measurements. Transverse views were inadequate in 27% of patients, compared with 7% for longitudinal views (P=0.04). Changes in IVCci are sensitive to small changes in circulating volume. Measurements are most frequently achieved in the longitudinal plane. There is an urgent need for standardization of sonographic IVC measurement techniques.

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“…Diameters were measured by calipers using the trailing edge-to-the leading edge technique. We used pulmonary venous flow and IVC data to estimate the venous return alterations during and after the race (11,32).…”

Section: Methodsmentioning

confidence: 99%

Progressive and biphasic cardiac responses during extreme mountain ultramarathon

Maufrais

Millet

Schuster

et al. 2016

American Journal of Physiology-Heart and Circulatory Physiology

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Maufrais C, Millet GP, Schuster I, Rupp T, Nottin S. Progressive and biphasic cardiac responses during extreme mountain ultramarathon. Am J Physiol Heart Circ Physiol 310: H1340 -H1348, 2016. First published February 26, 2016 doi:10.1152/ajpheart.00037.2016.-Investigations on the cardiac function consequences of mountain ultramarathon (MUM) Ͼ100 h are lacking. The present study assessed the progressive cardiac responses during the world's most challenging MUM (Tor des Géants; Italy; 330 km; 24,000 m of cumulative elevation gain). Resting echocardiographic evaluation of morphology, function, and mechanics of left and right ventricle (LV and RV) including speckle tracking echocardiography was conducted in 15 male participants (46 Ϯ 13 yr) before (pre), during (mid; 148 km), and after (post) the race. Runners completed the race in 126 Ϯ 15 h. From pre to post, the increase in stroke volume (SV) (103 Ϯ 19 vs. 110 Ϯ 23 vs. 116 Ϯ 21 ml; P Ͻ 0.001 at pre, mid, and post) was concomitant to the increase in LV early filling (peak E; 72.9 Ϯ 15.7 vs. 74.6 Ϯ 13.1 vs. 82.1 Ϯ 11.5 cm/s; P Ͻ 0.05). Left and right atrial end-diastolic areas, RV end-diastolic area, and LV enddiastolic volume were 12-19% higher at post compared with pre (P Ͻ 0.05). Resting heart rate and LV systolic strain rates demonstrated a biphasic adaptation with an increase from pre to mid (55 Ϯ 8 vs. 72 Ϯ 11 beats/min, P Ͻ 0.001) and a return to baseline values from mid to post (59 Ϯ 8 beats/min). Significant correlations were found between pre-topost percent changes in peak E and LV end-diastolic volume (r ϭ 0.63, P Ͻ 0.05) or RV (r ϭ 0.82, P Ͻ 0.001) or atrial end-diastolic areas (r ϭ 0.83, P Ͻ 0.001). An extreme MUM induced a biphasic pattern of heart rate in parallel with specific cardiac responses characterized by a progressive increase in diastolic filling, biventricular volumes, and SV. IT IS WELL DOCUMENTED THAT prolonged intense exercise, such as a marathon or Ironman triathlon, transitorily alters cardiac function (7,13,20,22,23,28,42). A range of 3-15 h exercising induces transient left ventricular (LV) global systolic (20, 42) and diastolic (7,23,28) dysfunctions. This phenomenon, named exercise-induced cardiac fatigue (EICF), is generally associated with the release of biochemical markers of myocardial damage (13,22).Whereas the impact of races such as marathons or Ironman triathlons has been extensively described, few studies have explored cardiac function after ultraendurance exercise. After 24 -26 h of exercise, previous studies observed a depressed diastolic function (5,24,29,30,35). However, conflicting results were observed on systolic function because ejection fraction (EF) was either decreased (24, 29, 35) or unchanged (5, 30). Recently, we evaluated the cardiac function consequences of a mountain ultramarathon (MUM) (i.e., 38 Ϯ 5 h). It is important to note that an important decrease in velocity (e.g., large deceleration) has been reported in the MUM of the present study (34), caused by the combination of extreme distance and sleep d...

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Point-of-Care Ultrasound to Estimate Central Venous Pressure

Abstract: Among spontaneously breathing patients largely without vasopressor support, the maximal inferior vena cava diameter is a more robust estimate of central venous pressure than the inferior vena cava collapsibility index or the internal jugular vein aspect ratio.

Cited by 103 publications

References 32 publications

COUNTERPOINT: Should Acute Fluid Resuscitation Be Guided Primarily by Inferior Vena Cava Ultrasound for Patients in Shock? No

COUNTERPOINT: Should Acute Fluid Resuscitation Be Guided Primarily by Inferior Vena Cava Ultrasound for Patients in Shock? No

Best approach to measuring the inferior vena cava in spontaneously ventilating patients

Progressive and biphasic cardiac responses during extreme mountain ultramarathon

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