Transthoracic echocardiography to evaluate the superior vena cava in critically ill patients: window description and pilot study

Ugalde, Diego; Haruel, Pierre-Alexandre; Prigent, Arnaud; Vieillard‐Baron, Antoine

doi:10.1007/s00134-019-05621-1

Cited by 7 publications

(12 citation statements)

References 6 publications

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“…In the existing studies, however, the SVC measurement was available in almost every ventilated patient by TEE [ 21 ]. Ugalde D and his colleagues recently provided a practical method of imaging SVC from a left parasternal view in its longitudinal axis and proved its feasibility in critically ill patients [ 12 ]. In our study, we excluded 9 (11.4%) subjects whose SVC views were not obtainable, which is in line with the pilot study conducted by Ugalde D et al We concluded that an SVCCI ≥ 19% measured with TTE predicted responders correctly with sensitivity and specificity of 93.3% and 75% respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Fourth, we did not acquire the SVC image by the conventional TEE approach to appraise the correlation between the SVC-derived parameters. However, the transthoracic acquisition of SVC was equivalent to the TEE approach in image quality and measurement [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…The longitudinal axis of SVC was obtained from a left parasternal view using the two-dimensional view according to the methodology described and validated in previous studies by Ugalde D et al [ 12 ], with the patients in a semi-recumbent position. Pulse wave Doppler and visualization of a central venous catheter were used to differentiate the SVC from nearby structures.…”

Section: Methodsmentioning

confidence: 99%

“…Among these echocardiographic variables, superior vena cava (SVC) collapsibility index (SVCCI), and SVC variation over the cardiac cycle (SVCV) have shown promising results in mechanically ventilated patients, but SVC measurements required transesophageal echocardiography (TEE) technique, which currently limited its routine clinical application [ 9 – 11 ]. With the introduction of SVC acquisition through transthoracic echocardiography (TTE) approach, it is, therefore, possible to determine volume responsiveness by measuring SVC variation using a noninvasive approach [ 12 ]. The objective of the present study was to evaluate and compare the predictive value of SVCCI and SVCV acquisition from transthoracic ultrasound with inferior vena cava distensibility index (dIVC) in fluid responsiveness for mechanically ventilated patients following abdominal surgery.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of superior and inferior vena cava diameter variation measured with transthoracic echocardiography to predict fluid responsiveness in mechanically ventilated patients after abdominal surgery

Shi

et al. 2022

BMC Anesthesiol

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Background The volume status of patients after major abdominal surgery constantly varies owing to postoperative diverse issues comprising fluid loss or capillary leakage secondary to systemic inflammatory reaction syndrome, et.al, the precise fluid responsiveness assessment is crucial for those patients. The purpose of this study is to validate the transthoracic ultrasonographic measurement of superior and inferior vena cava variation in predicting fluid responsiveness of mechanically ventilated patients after surgery. Methods A total of 70 patients undergoing the scheduled major abdominal surgeries in the anesthesia ICU ward were included. The superior vena cava (SVC) collapsibility index (SVCCI), the inferior vena cava distensibility index (dIVC), SVC variation over the cardiac cycle (SVCV), and cardiac output (CO) were measured by transthoracic ultrasonography were recorded before and after fluid challenge test of 5 ml/kg crystalloid within 15 min. The responders were defined as a 15% or more increment in CO. Results Thirty patients (42.9%) responded to fluid challenge, while the remnant forty patients (57.1%) did not. The areas under the ROC curve (AUC) of SVCCI, dIVC and SVCV were 0.885 (95% CI, 0.786–0.949; P < 0.0001) and 0.727 (95% CI, 0.608–0.827; P < 0.001) and 0.751 (95% CI, 0.633–0.847; P < 0.0001), respectively. AUCdIVC and AUCSVCV were significantly lower when compared with AUCSVCCI (P < 0.05). The optimal cutoff values were 19% for SVCCI, 14% for dIVC, and 15% for SVCV. The gray zone for SVCCI was 20%-25% and included 15.7% of patients, while 7%-27% for dIVC including 62.9% of patients and 9%-21% for SVCV including 50% of patients. Conclusion Superior vena cava-related parameters measured by transthoracic ultrasound are reliable indices to predict fluid responsiveness. The accuracy of SVCCI in mechanically ventilated patients after abdominal surgery is better than that of dIVC and SVCV. Trial registration ChiCTR-INR-17013093. The initial registration date was 24/10/2017.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of superior and inferior vena cava diameter variation measured with transthoracic echocardiography to predict fluid responsiveness in mechanically ventilated patients after abdominal surgery

Shi

et al. 2022

BMC Anesthesiol

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“…All transthoracic ultrasound measurements were performed by a professional investigator in echocardiography using a Philips EPIQ 7C machine (Philips Healthcare, Andover, Massachusetts). The longitudinal axis of the SVC was obtained from the left parasternal region according to the methodology described in the previous studies conducted by Ugalde et al [ 6 ], with the patients in a semi-recumbent position ( Figures 1 , 2 ). SVC collapsibility index (SVCCI) was calculated as SVCCI = (SVCmax – SVCmin)/SVCmax.…”

mentioning

confidence: 99%

Clinical validation of superior vena cava respiratory variation in predicting fluid responsiveness using transthoracic echocardiography technique: a pilot study

Shi

et al. 2022

Arch Med Sci

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Diagnostic Value of Contrast‐Enhanced Ultrasonography for Catheter‐Related Right Brachiocephalic Vein and Superior Vena Cava Lesions in Patients Undergoing Hemodialysis—A Pilot Study

Fen,

Yin,

Li‐ming

et al. 2023

J of Ultrasound Medicine

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ObjectivesTo evaluate the diagnostic efficacy of contrast‐enhanced ultrasonography (CEUS) for detecting catheter‐related right brachiocephalic vein (RBV) and superior vena cava (SVC) obstructions in patients undergoing hemodialysis (HD).MethodsFrom June 1, 2021 to December 31, 2022, we enrolled 80 patients undergoing HD who had used or were using a central venous catheter as vascular access. We evaluated the diagnostic efficacy of conventional ultrasonography and CEUS for identifying RBV and SVC obstructions and compared them with that of digital subtraction angiography (DSA). In the stratified analysis, the SVC was divided into the upper and lower segments. In total, we analyzed 240 central venous segments, including the RBV.ResultsAmong the RBV and SVC visualized by DSA, conventional ultrasonography and CEUS could visualize 67.92 and 100% of the vein segments, respectively; however, the lengths and diameters of the RBV and SVC were smaller than those recorded with DSA (P < .001). The diagnostic efficacy of CEUS for detecting catheter‐related central venous obstruction was better than that of conventional ultrasonography, with a higher sensitivity (83.95 vs 41.98%), specificity (89.94 vs 53.46%), accuracy (87.92 vs 49.58%), and F1 score (82.42 vs 49.64%). CEUS showed good agreement (κ = 0.732) with DSA. In the stratified analyses, CEUS also showed higher sensitivity (83.93, 83.33, and 84.62%, respectively) and better agreement with DSA (κ = 0.635, 0.655, and 0.673, respectively) than conventional ultrasonography for detecting the RBV and the upper and lower segments of the SVC.ConclusionsCEUS had high sensitivity and specificity in diagnosing catheter‐related RBV and SVC obstructions.

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Transthoracic echocardiography to evaluate the superior vena cava in critically ill patients: window description and pilot study

Cited by 7 publications

References 6 publications

Comparison of superior and inferior vena cava diameter variation measured with transthoracic echocardiography to predict fluid responsiveness in mechanically ventilated patients after abdominal surgery

Comparison of superior and inferior vena cava diameter variation measured with transthoracic echocardiography to predict fluid responsiveness in mechanically ventilated patients after abdominal surgery

Clinical validation of superior vena cava respiratory variation in predicting fluid responsiveness using transthoracic echocardiography technique: a pilot study

Diagnostic Value of Contrast‐Enhanced Ultrasonography for Catheter‐Related Right Brachiocephalic Vein and Superior Vena Cava Lesions in Patients Undergoing Hemodialysis—A Pilot Study

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