Agreement between inferior vena cava diameter measurements by subxiphoid versus transhepatic views

Kulkarni, Atul P; Janarthanan, Sailajah; Harish, M M; Suhail, S.; Chaudhari, Harish K; Agarwal, Vandana; Patil, Vijaya; Divatia, Jigeeshu V.

doi:10.4103/0972-5229.171390

Cited by 22 publications

(18 citation statements)

References 16 publications

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“…We observed a better correlation between the SC and TH views when the F-IVC was above 0.75 than when it was below Previous studies evaluating the TH approach (also called the right lateral or midaxillary approach) concluded that this view could be a surrogate for the SC view in IVC assessment. 9,[11][12][13] As in our study, a correlation was found between the SC and TH views with a low bias in the Bland and Altman analysis. [11][12][13] However, the limits of agreement were always wide, questioning the relevance of the TH view as a surrogate for the SC view.…”

Section: Re Sultssupporting

confidence: 79%

“…9,[11][12][13] As in our study, a correlation was found between the SC and TH views with a low bias in the Bland and Altman analysis. [11][12][13] However, the limits of agreement were always wide, questioning the relevance of the TH view as a surrogate for the SC view. 11,12 In the present study, the limits of agreement found were not clinically acceptable because of an error of approximately 7-8 mm for the IVC diameter measurements.…”

Section: Re Sultssupporting

confidence: 79%

“…[11][12][13] However, the limits of agreement were always wide, questioning the relevance of the TH view as a surrogate for the SC view. 11,12 In the present study, the limits of agreement found were not clinically acceptable because of an error of approximately 7-8 mm for the IVC diameter measurements. Analysis of IVC respiratory variation led to better results, as in previous studies.…”

Section: Re Sultsmentioning

confidence: 99%

“…[8][9][10][11][12][13] With a modest correlation between the SC and TH approaches, a number of authors concluded that the TH view can replace the SC view when the latter is not available. 9,[11][12][13] However, few of these studies have focused on critically ill patients, and their methodology makes it difficult to reach firm conclusions on the utility of the TH view in the ICU. The aim of this study was to explore whether the TH view could be used as a surrogate to the SC view in the assessment of the IVC in critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

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Subcostal versus transhepatic view to assess the inferior vena cava in critically ill patients

et al. 2020

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Background Evaluation of the inferior vena cava (IVC) is not always possible through the subcostal (SC) window. Methods Inferior vena cava diameters measured by transhepatic (TH) and SC views were compared by Bland and Altman analysis. Results 131 patients were enrolled, including 88 (67%) under mechanical ventilation. The echogenicity was statistically poorer through the TH view in comparison with the SC view (P = .002). The correlation between the SC and TH views was good and better for respiratory variation than for end‐expiratory or end‐inspiratory diameter measurements (r = 0.86). Despite low bias, the limits of agreement were wide (−7.5 and 7.7 mm for end‐expiratory diameter, −8.7 and 8.5 mm for end‐inspiratory diameter, and −5.3 and 5.8 mm for respiratory variation). Complementary analysis showed that the concordance between the SC and the TH views was better when the IVC was distended. However, the limits of agreement remained broad. Conclusions Although feasible in almost all patients, the TH view does not provide better echogenicity in comparison with the SC view. Despite a good correlation with the SC view and a low bias, the limits of agreement were wide, especially when the IVC has an ellipsoidal shape, suggesting caution in the interpretation of data obtained by the TH view.

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Section: Re Sultssupporting

confidence: 79%

Section: Re Sultssupporting

confidence: 79%

Section: Re Sultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subcostal versus transhepatic view to assess the inferior vena cava in critically ill patients

et al. 2020

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“…Beim schlafenden Neugeborenen sind diese Differenzen des Diameters zwischen Inspiration und Exspiration marginal und die ausschließliche Messung in der Exspirationsphase möglich. Dies wird durch vorliegende Arbeiten bestätigt, wie auch die optimalen Messpunkte, die für die Aorta abdominalis 1 cm vor dem Abgang der Arteria mesenterica superior und für die Vena cava inferior in Höhe des Konfluenz der Venae hepaticae anzustreben sind [11,12,18,19]. Zudem ermöglichen der Längsschnitt und die Einstellung beider Gefäße einen direkten, wenn auch subjektiven visuellen Vergleich der Weite der Gefäße und damit ihrer Füllung.…”

Section: Diskussionunclassified

Index aus Diameter der Vena cava inferior und Aorta abdominalis bei Neugeborenen – eine praxisrelevante Methode zur Erfassung einer Hypovolämie

Behnke¹,

Robel-Tillig

2020

Z Geburtshilfe Neonatol

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ZusammenfassungBei kranken Neugeborenen steht häufig eine Hypovolämie im Vordergrund der klinischen Probleme. Eine effiziente, schonende Diagnostik ist für eine adäquate Therapie entscheidend. Sonografische Untersuchungen entsprechen diesen Anforderungen. Um die Volumensituation der Kinder zu beurteilen, wird eine Relation aus Durchmessern der Vena cava inferior (IVC) und der Aorta abdominalis (Ao) erfasst. Patienten und Methoden 97 reife, gesunde Neugeborene wurden am 1. und 3. Tag untersucht. Es erfolgte an definierten Punkten die Messung der Diameter der IVC, Ao und Berechnung des Index IVC/Ao. Korrelationsanalysen wurden zur Ermittlung der Abhängigkeit der Messungen vom Geburtsgewicht und Gewichtsverlust in den ersten 3 LT. durchgeführt. Ergebnisse Der Durchmesser der Ao betrug am 1. Tag 6,1 (+/−0,6) mm, am 3. Tag 6,2 (+/−0,6) mm, der Diameter der IVC am 1. Tag 2,5 (+/−0,5) mm, am 3. Tag 2,6 (+/−0,5) mm. Der Index aus IVC/ Ao lag bei 0,4 (+/−0,1) am 1.Tag, 0,4 (+/−0,1) am 3. Tag. und korreliert mit dem Geburtsgewicht. Es ließ sich ein signifikanter Unterschied zwischen den Indices bei SGA- und LGA- Neugeborenen feststellen (0.36 vs 0,47). Die Gewichtsabnahme von 1. zum 3. LT (160+/−216 g) hatte keinen Einfluss auf die Diameter und Index der Gefäße. Schlussfolgerung Die Studie liefert Normalwerte für die Diameter der Ao, IVC sowie des Index. Damit ist eine Einschätzung des Volumenzustandes möglich. Die Ergebnisse können ebenso einen Beitrag zum Verständnis der Pathophysiologie bei SGA- Neonaten sein.

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Ultrasound assessment of the inferior vena cava in children: A comparison of sub‐xiphoid and right lateral coronal views

Yamaguchi

Moharir

Kim

et al. 2021

J of Clinical Ultrasound

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Objectives The inferior vena cava collapsibility index (IVCCI) has been used to assess the respiratory variation of the inferior vena cava (IVC) diameter and hence intravascular volume. The sub‐xiphoid view (SXV) is the standard view to evaluate the IVC. The right lateral transabdominal view (RLV) has been shown in adults to be an alternative view to evaluate the IVC when the SXV is not feasible. The aim of the study was to compare IVC dimensions from these two views and thus determine whether the RLV view can be used instead of the SXV in pediatric patients. Methods We conducted a single‐center prospective observational crossover study. Study subjects were ASA physical status 1–2 children, 1–12 years of age scheduled for elective surgery under general anesthesia. Anesthesia was maintained by mask with spontaneous ventilation with end‐tidal sevoflurane at 2%–5% after the induction of anesthesia. IVCCI was measured using M‐mode in both the SXV and RLV. Results The study cohort included 50 children with a mean age of 5.1 years. The median value for the IVCCI‐sx was 0.45 (IQR: 0.28–0.70) while the IVCCI‐rl was 0.30 (0.19–0.5). The mean difference between the two groups was 0.12 (95% CI: 0.177–0.066, p < .001, two‐tailed paired t‐test). Spearman's rank correlation coefficient was 0.66. The univariate linear regression model was IVCCIsx = 0.21 + 0.77 × IVCCIrl. Conclusions IVCCIrl was lower than IVCCIsx. IVCCI measured from the right lateral view tended to overestimate the patient's fluid‐responsiveness and therefore these two values are not interchangeable.

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Agreement between inferior vena cava diameter measurements by subxiphoid versus transhepatic views

Cited by 22 publications

References 16 publications

Subcostal versus transhepatic view to assess the inferior vena cava in critically ill patients

Subcostal versus transhepatic view to assess the inferior vena cava in critically ill patients

Index aus Diameter der Vena cava inferior und Aorta abdominalis bei Neugeborenen – eine praxisrelevante Methode zur Erfassung einer Hypovolämie

Ultrasound assessment of the inferior vena cava in children: A comparison of sub‐xiphoid and right lateral coronal views

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