Comparison of superior vena cava and inferior vena cava diameter changes by echocardiography in predicting fluid responsiveness in mechanically ventilated patients

Upadhyay, Vishal; Malviya, Deepak; Nath, Soumya Sankar; Tripathi, Manoj Kumar; Jha, Ashish

doi:10.4103/aer.aer_1_21

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…The diagnostic ability of IVC measurements to predict FR has been investigated in ICU patients with shock of any type, using passive leg rising (PLR) maneuver as a fluid challenge method. [70][71][72][73] The optimal threshold points of dIVC reported were higher than in patients with tidal volumes >8 ml/kg; ranging from 23% to 29% (demonstrating a moderate performance) with a sensitivity of 47%-80% and a specificity of 86%-87% (Table 4). Conversely, Taccheri et al 70 reported that in patients ventilated with a low tidal volume (6 ml/kg), the dIVC could not reliably predict the FR.…”

Section: Tidal Volume Less Than 8 Ml/kgmentioning

confidence: 99%

“…Low tidal volumes used in lung protective ventilation are very common in critical care patients. [70][71][72][73] It is likely that low tidal volumes affect IVC-US measurements differently than higher tidal volumes.…”

Section: Tidal Volume Less Than 8 Ml/kgmentioning

confidence: 99%

“…It is likely that low tidal volumes affect IVC‐US measurements differently than higher tidal volumes. The diagnostic ability of IVC measurements to predict FR has been investigated in ICU patients with shock of any type, using passive leg rising (PLR) maneuver as a fluid challenge method 70–73 . The optimal threshold points of dIVC reported were higher than in patients with tidal volumes >8 ml/kg; ranging from 23% to 29% (demonstrating a moderate performance) with a sensitivity of 47%–80% and a specificity of 86%–87% (Table 4).…”

Section: Ivc Measurements and Responsiveness To Fluidsmentioning

confidence: 99%

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Inferior vena cava ultrasonography in the assessment of intravascular volume status and fluid responsiveness in the emergency department and intensive care unit: A critical analysis review

Spiliotaki

Saranteas

Moschovaki

et al. 2022

J of Clinical Ultrasound

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Rapid evaluation of intravascular volume status is vital; either excessive or limited fluid administration may result in adverse patient outcomes. In this narrative review, critical analysis of pertinent diagnostic accuracy studies is developed to delineate the role of inferior vena cava ultrasound measurements in the assessment of both intravascular volume status and fluid responsiveness in the emergency department and intensive care unit. In addition, limitations, and technical considerations of inferior vena cava ultrasound measurements as well as directions for future research are thoroughly discussed.

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Section: Tidal Volume Less Than 8 Ml/kgmentioning

confidence: 99%

Section: Tidal Volume Less Than 8 Ml/kgmentioning

confidence: 99%

Section: Ivc Measurements and Responsiveness To Fluidsmentioning

confidence: 99%

See 1 more Smart Citation

Inferior vena cava ultrasonography in the assessment of intravascular volume status and fluid responsiveness in the emergency department and intensive care unit: A critical analysis review

Spiliotaki

Saranteas

Moschovaki

et al. 2022

J of Clinical Ultrasound

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“…14 The cutoff for SVC collapsibility using transesophageal echo is 35%. 15 Another dynamic parameter is the maximal velocity through the LVOT, which can be measured using continuous wave Doppler with high sensitivity.…”

Section: Right Ventricle (Rv)mentioning

confidence: 99%

Echocardiography in the Assessment of Shock

Arshed,

Madhivathanan,

Roshdy

2024

Journal of Acute Care

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The skills, training, and approach can differ from one place to another, but it is generally recommended to follow a unique systematic approach in the same setting due to the usual need for serial studies by different operators.The study can be focused or comprehensive. A systemic approach makes it easier to reveal the shock etiology and spot the hemodynamic parameter in need of correction (e.g., flow obstruction, volume responsiveness, inotropes, and vasoconstrictors). It is important to note that several mechanisms can interplay and hence the need for a comprehensive approach.Based on our experience, we describe below our stepwise approach (Fig. 1):Step 1: Confirm Shock State This is usually a clinical diagnosis combined with biomarkers (e.g., mottling, capillary refill time, low urine output, lactate, and central venous oxygen saturation). However, some novel POCUS

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“…Moreover, it is subject to erroneous interpretations due to inadvertent application of excess transducer pressure, limited access to the neck because of the presence of central venous catheters, tracheostomy collars, braces etc. On the other hand, superior vena cava ultrasound has been studied in the context of predicting fluid responsiveness and shown to perform better than IVC[ 61 ]. However, transesophageal echocardiography is required to reliably access the vessel, which is not routinely performed in all clinical settings.…”

Section: Internal Jugular Vein and Superior Vena Cava Ultrasoundmentioning

confidence: 99%

Point of care venous Doppler ultrasound: Exploring the missing piece of bedside hemodynamic assessment

Galindo¹,

Gasca²,

Argaiz³

et al. 2021

WJCCM

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Accurate assessment of the hemodynamic status is vital for appropriate management of patients with critical illness. As such, there has been a constant quest for reliable and non-invasive bedside tools to assess and monitor circulatory status in order to ensure end-organ perfusion. In the recent past, point of care ultrasonography (POCUS) has emerged as a valuable adjunct to physical examination in various specialties, which basically is a clinician-performed bedside ultrasound to answer focused questions. POCUS allows visualization of the internal anatomy and flow dynamics in real time, guiding apt interventions. While both arterial (forward flow) and venous (organ outflow or afterload) limbs of hemodynamic circuit are important for tissue perfusion, the venous side remains relatively under-explored. With recent data underscoring the deleterious consequences of iatrogenic volume overload, objective evaluation of venous congestion is gaining attention. Bedside Doppler ultrasound serves this purpose and aids in diagnosing and monitoring the congestion/venous blood flow pattern. In this article, we summarize the rationale for integrating this technology into routine care of patients with volume-related disorders, discuss the normal and abnormal waveforms, limitations, and future directions.

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Comparison of superior vena cava and inferior vena cava diameter changes by echocardiography in predicting fluid responsiveness in mechanically ventilated patients

Cited by 5 publications

References 23 publications

Inferior vena cava ultrasonography in the assessment of intravascular volume status and fluid responsiveness in the emergency department and intensive care unit: A critical analysis review

Inferior vena cava ultrasonography in the assessment of intravascular volume status and fluid responsiveness in the emergency department and intensive care unit: A critical analysis review

Echocardiography in the Assessment of Shock

Point of care venous Doppler ultrasound: Exploring the missing piece of bedside hemodynamic assessment

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