Caudal vena cava collapsibility index in healthy cats by ultrasonography

Alves, Fabiana; Miranda, F.G.; Rezende, R.Z.; Souza, I.P.; Tôrres, R.C.S.; Rezende, C.M.F.; Nepomuceno, Anelise Carvalho

doi:10.1590/1678-4162-11366

Cited by 3 publications

(6 citation statements)

References 15 publications

(18 reference statements)

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“…In the present study, the expiratory/maximum and inspiratory/minimum diameters of the caudal vena cava in nonresponsive patients coincide with the reference values previously reported in healthy cats 30 . On the other hand, both expiratory/maximum and inspiratory/minimum diameters in fluid‐responsive cats were lower than those observed in healthy cats 30 …”

Section: Discussionsupporting

confidence: 91%

“…30 On the other hand, both expiratory/maximum and inspiratory/minimum diameters in fluid-responsive cats were lower than those observed in healthy cats. 30 In a recent study carried out in hospitalized dogs with hemodynamic alterations, CVCCI was shown to be an excellent predictor of response to fluids. 12 The AUROC curve for CCVCC (0.96) was higher than that observed in the present study.…”

Section: Discussionmentioning

confidence: 85%

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Caudal vena cava measurements and fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion

Donati

Tunesi²,

Araos

2022

J Vet Emergen Crit Care

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Objective To evaluate the use of the caudal vena cava collapsibility index (CVCCI) and the inspiratory/minimum and expiratory/maximum diameters of the vena cava to predict fluid responsiveness in hospitalized, critically ill cats with hemodynamic and tissue perfusion abnormalities. Design Diagnostic test study in a prospective cohort of hospitalized cats. Setting Private practice referral hospital. Animals Twenty‐four hospitalized cats with spontaneous breathing and compromised hemodynamics and tissue hypoperfusion. Interventions Ultrasonographic examination before and after fluid expansion with 10 ml/kg of lactated Ringer's solution. Measurements and Main Results Fluid responsiveness was evaluated using the velocity–time integral (VTI) of the subaortic blood flow, by measuring it before and after a fluid load of 10 ml/kg of lactated Ringer's solution. The CVCCI was calculated using the following formula: (maximum diameter – minimum diameter / maximum diameter) × 100. Ten cats were fluid responders (42 %) and 14 were nonresponders (58 %). The area under the receiver operating characteristic curve (AUROC) with their 95% confidence interval for the predictors and the best cutoff values were as follows: CVCCI, AUROC = 0.83 (0.66–1.00) and cutoff = 31%; inspiratory/minimum diameter, AUROC = 0.86 (0.70–1.00) and cutoff = 0.24 cm; expiratory/maximum diameter, AUROC = 0.88 (0.74–1.00) and cutoff = 0.22 cm. A significant lineal correlation was observed between the percentage of increase in VTI after expansion and CVCCI (rs = 0.68, P < 0.001), expiratory/maximum diameter (rs = –0.72, P < 0.001), and inspiratory/minimum diameter (rs = –0.71, P < 0.001). The intraobserver and interobserver variability was low for VTI, and the expiratory/maximum diameter and inspiratory/minimum diameter were high for CVCCI. Conclusions Caudal vena cava measurements could be useful to predict the response to fluids in hospitalized cats with hemodynamic and tissue perfusion alterations. Additional studies are required to draw definitive conclusions about the role of these variables to guide fluid administration in cats.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 85%

Caudal vena cava measurements and fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion

Donati

Tunesi²,

Araos

2022

J Vet Emergen Crit Care

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“…A study in 15 healthy cats reports CVC diameter measurements obtained from the HV. 21 A study in 21 healthy cats anaesthetised for blood donation reported CVC measurements at the SV, HV and PV. 20 The authors reported 100% success rates at the SV but an inability to obtain images at three and seven attempts for the HV and PV, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…20 Another study examining the CVC-CI in a group of 15 healthy awake cats via the right HV showed a CI of 28% ± 3% at this location. 21…”

Section: Introductionmentioning

confidence: 99%

“…20 Another study examining the CVC-CI in a group of 15 healthy awake cats via the right HV showed a CI of 28% ± 3% at this location. 21 Historically, most small animal point-of-care ultrasound (POCUS) examinations, including CVC evaluation in dogs, have been performed in lateral recumbency. 18,22 In contrast, a standing position has been used in foals.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonographically derived caudal vena cava parameters acquired in a standing position and lateral recumbency in healthy, lightly sedated cats: a pilot study

Hultman

Boysen

Owen

et al. 2021

Journal of Feline Medicine and Surgery

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Objectives The aim of this study was to determine the feasibility of ultrasonographically measuring the caudal vena cava (CVC) at the subxiphoid view of healthy, lightly sedated cats in a standing position and lateral recumbency. Methods This was a prospective, observational, experimental single-centre study. Twenty healthy research-purposed cats were enrolled. Two trained operators scanned each cat in two positions – standing and lateral recumbency – in a randomised order. CVC diameter was measured at the narrowest diameter during inspiration and at the widest diameter during expiration, at two anatomical locations along the CVC – where the CVC crosses the diaphragm (base) and 2 mm caudal to the diaphragm. The CVC collapsibility index (CVC-CI) was calculated for each site. Normalcy was assessed with a Shapiro–Wilk test. A one-way ANOVA with post-hoc Tukey’s test was used to compare inspiratory with expiratory values within and between groups. A paired t-test compared the CVC-CI between groups ( P ⩽0.05 indicated statistical significance). Spearman’s correlation and Bland–Altman analysis assessed inter-operator variability. Results All ultrasonographic data passed normalcy and were reported as mean ± SD. When compared with each other, inspiratory and expiratory values were statistically different for position, location and operator (all P <0.0001). There was no statistically significant difference between lateral recumbency or standing position for inspiratory, expiratory and CVC-CI values. Inter-operator variability was substantial, with operator 2 consistently obtaining smaller measurements than operator 1. The mean CVC-CI in lateral recumbency at the base was 24% for operator 1 and 37% for operator 2. For the same site in standing position, CVC-CI was 27% and 41% for operators 1 and 2, respectively. Conclusions and relevance This pilot study demonstrates that it is possible to ultrasonographically measure the CVC diameter in both lateral recumbency and a standing position in healthy, lightly sedated cats. However, measurements obtained are operator dependent with variability between individuals. Further studies are needed to determine if ultrasonographic CVC assessment will prove helpful in estimating intravascular volume status in cats.

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Establishment of reference intervals for ultrasonographically derived caudal vena cava parameters from 110 healthy, lightly sedated cats

Hultman,

Rosanowski,

Jalava

et al. 2023

Journal of Feline Medicine and Surgery

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Objectives The present study aimed to establish reference intervals (RIs) for ultrasonographically derived caudal vena cava (CVC) parameters in healthy cats. Methods A prospective, observational, experimental single-centre study involving 110 cats was conducted. Two trained operators scanned all cats in a randomised order. Two sets of cine loops per cat were conducted by each operator from the subxiphoid view with cats in lateral recumbency. Two blinded raters measured the narrowest inspiratory (CVCinsp) and widest expiratory (CVCexp) diameter over two separate respiratory cycles for each operator (four measurements in total for each rater) at the point the CVC crosses the diaphragm. The CVC collapsibility index (CVCCI) was calculated. Reference intervals and limits were calculated for CVC parameters with outliers removed to include the central 95% of CVC values and the non-parametric 90% confidence intervals (90% CIs). The CVCCI interval included the central 95th (2.5th and 97.5th) centiles bounded by the 90% CI. Intra- and inter-rater and intra- and inter-operator reliabilities were calculated for each parameter using a two-way random-effects model. A Bland–Altman plot was used to visualise the CVCCI between the two raters. Results In total, 880 measurements were included for each diameter and 440 CVCCI values were calculated. The CVC diameters were normally distributed, whereas the CVCCI was not. The calculated RIs were 1.4–6.1 mm for CVCinsp and 2.2–6.7 mm for CVCexp. The median (range) CVCCI was 23% (11–36%) with 2.5th and 97.5th centiles of 2% and 67%, respectively. There was a moderate to good intra-rater and intra-operator reliability for CVC diameter. The intra-rater reliability for the CVCCI was moderate. The inter-rater and inter-operator reliabilities for the CVCCI were poor. Conclusions and relevance The CVC RIs determined from the subxiphoid site in cats appear to be wider than those reported in dogs, and rater and operator variability is present. Whether precise measurements of CVC parameters are suitable to guide clinical decisions remains to be determined.

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Caudal vena cava collapsibility index in healthy cats by ultrasonography

Cited by 3 publications

References 15 publications

Caudal vena cava measurements and fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion

Caudal vena cava measurements and fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion

Ultrasonographically derived caudal vena cava parameters acquired in a standing position and lateral recumbency in healthy, lightly sedated cats: a pilot study

Establishment of reference intervals for ultrasonographically derived caudal vena cava parameters from 110 healthy, lightly sedated cats

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