Correlations between pulmonary artery pressures and inferior vena cava collapsibility in critically ill surgical patients: An exploratory study

Stawicki, Stanislaw P.; Papadimos, Thomas J.; Bahner, David P.; Evans, David C.; Jones, Christian

doi:10.4103/2229-5151.195449

Cited by 8 publications

(9 citation statements)

References 35 publications

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“…The CVC changes diameter during the respiratory cycle . With inspiration, the CVC diameter in the cranial abdomen decreases and with expiration it increases.…”

mentioning

confidence: 98%

“…Recent studies have identified numerous deficiencies with the current methods used to estimate fluid status, including heart rate, blood pressure, physical examination findings, and laboratory findings . A rapid and noninvasive method recently investigated to assess fluid status in humans involves the use of sonography to measure the change in diameter of the caudal vena cava (CVC) with inspiration and expiration …”

mentioning

confidence: 99%

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Influence of the Respiratory Cycle on Caudal Vena Cava Diameter Measured by Sonography in Healthy Foals: A Pilot Study

Tuplin

Romero

Boysen

2017

Veterinary Internal Medicne

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BackgroundIntravascular volume assessment in foals is challenging. In humans, intravascular volume status is estimated by the caudal vena cava (CVC) collapsibility index (CVC‐CI) defined as (CVC diameter at maximum expiration [CVC max] – CVC diameter at minimal inspiration [CVC min])/CVC max × 100%.Hypothesis/ObjectivesTo determine whether the CVC could be sonographically measured in healthy foals, determine differences in CVC max and CVC min, and calculate inter‐ and intrarater variability between 2 examiners. We hypothesized that the CVC could be measured sonographically at the subxiphoid view and that there would be a difference between CVC max and CVC min values.AnimalsSixty privately owned foals <1‐month‐old.MethodsProspective study. A longitudinal subxiphoid sonographic window in standing foals was used. The CVC max and CVC min were analyzed by a linear mixed effect model. Inter‐rater agreement and intrarater variability were expressed by Bland‐Altman and intraclass correlation coefficients, respectively.ResultsMeasurements were attained from 58 of 60 foals with mean age of 15 ± 7.9 days and mean weight of 75.7 ± 17.7 kg. The CVC max was significantly different from CVC min (D = 0.515, SE = 0.031, P < 0.001). Inter‐rater agreement of the CVC‐CI differed by an average of −0.9% (95% limits of agreement, −12.5 to +10.7%). Intrarater variability of CVC max was 0.540 and 0.545, of CVC min was 0.550 and 0.594, and of CVC‐CI was 0.894 and 0.853 for observers 1 and 2, respectively.Conclusions and Clinical ImportanceThese results indicate it is possible to reliably measure the CVC sonographically in healthy foals, and the CVC‐CI may prove useful in assessing the intravascular volume status in hypovolemic foals.

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“…The CVC changes diameter during the respiratory cycle . With inspiration, the CVC diameter in the cranial abdomen decreases and with expiration it increases.…”

mentioning

confidence: 98%

mentioning

confidence: 99%

Influence of the Respiratory Cycle on Caudal Vena Cava Diameter Measured by Sonography in Healthy Foals: A Pilot Study

Tuplin

Romero

Boysen

2017

Veterinary Internal Medicne

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“…In intensive care patients, IVCI correlates well with invasively measured central venous pressure and pulmonary artery pressure (Stawicki et al . ; Ilyas et al . ).…”

Section: Cardiorenal Syndromesmentioning

confidence: 99%

“…Another way to estimate an individual's intravascular filling state non-invasively is the ultrasound derived inferior vena cava collapsibility index (IVCI) (Finnerty et al 2017). In intensive care patients, IVCI correlates well with invasively measured central venous pressure and pulmonary artery pressure (Stawicki et al 2016;Ilyas et al 2017). In comparison to uncomplicated pregnancies, reduced IVCI was observed in late-onset but not in early-onset preeclampsia, suggesting a higher intravascular filling state in late-onset than in early-onset preeclampsia (Stergiotou et al 2013).…”

Section: Direct Cardiorenal Interactionsmentioning

confidence: 99%

Preeclampsia: a gestational cardiorenal syndrome

Gyselaers

Thilaganathan

2019

The Journal of Physiology

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It is generally accepted today that there are two different types of preeclampsia: an early‐onset or placental type and a late‐onset or maternal type. In the latent phase, the first one presents with a low output/high resistance circulation eventually leading in the late second or early third trimester to an intense and acutely aggravating systemic disorder with an important impact on maternal and neonatal mortality and morbidity; the other type presents initially as a high volume/low resistance circulation, gradually evolving to a state of circulatory decompensation usually in the later stages of pregnancy, with a less severe impact on maternal and neonatal outcome. For both processes, numerous dysfunctions of the heart, kidneys, arteries, veins and interconnecting systems are reported, most of them presenting earlier and more severely in early‐ than in late‐onset preeclampsia; however, some very specific dysfunctions exist for either type. Experimental, clinical and epidemiological observations before, during and after pregnancy are consistent with gestation‐induced worsening of subclinical pre‐existing chronic cardiovascular dysfunction in early‐onset preeclampsia, and thus sharing the pathophysiology of cardiorenal syndrome type II, and with acute volume overload decompensation of the maternal circulation in late‐onset preeclampsia, thus sharing the pathophysiology of cardiorenal syndrome type 1. Cardiorenal syndrome type V is consistent with the process of preeclampsia superimposed upon clinical cardiovascular and/or renal disease, alone or as part of a systemic disorder. This review focuses on the specific differences in haemodynamic dysfunctions between the two types of preeclampsia, with special emphasis on the interorgan interactions between heart and kidneys, introducing the theoretical concept that the pathophysiological processes of preeclampsia can be regarded as the gestational manifestations of cardiorenal syndromes.

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“…IVCI is defined as (IVmax − IVmin)/IVmax, where IVmax is the IVC diameter at maximal inspiration and IVmin at maximal expiration. In patients at intensive care units (ICU), IVCI correlates well with invasively measured central venous pressure and pulmonary artery pressure [38,39]. In comparison to uncomplicated pregnancies, reduced IVCI was observed in LPE but not in EPE, suggesting a higher intravascular filling state in LPE than in EPE [40].…”

Section: Renal Physiology In Normal Pregnancy and In Two Types Ofmentioning

confidence: 99%

Maternal Venous Hemodynamic Dysfunction in Proteinuric Gestational Hypertension: Evidence and Implications

Gyselaers

2019

JCM

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This review summarizes current knowledge from experimental and clinical studies on renal function and venous hemodynamics in normal pregnancy, in gestational hypertension (GH) and in two types of preeclampsia: placental or early-onset preeclampsia (EPE) and maternal or late-onset (LPE) preeclampsia, presenting at <34 weeks and ≥34 weeks respectively. In addition, data from maternal venous Doppler studies are summarized, showing evidence for (1) the maternal circulation functioning closer to the upper limits of capacitance than in non-pregnant conditions, with intrinsic risks for volume overload, (2) abnormal venous Doppler measurements obtainable in preeclampsia, more pronounced in EPE than LPE, however not observed in GH, and (3) abnormal venous hemodynamic function installing gradually from first to third trimester within unique pathways of general circulatory deterioration in GH, EPE and LPE. These associations have important clinical implications in terms of screening, diagnosis, prevention and management of gestational hypertensive diseases. They invite for further hypothesis-driven research on the role of retrograde venous congestion in the etiology of preeclampsia-related organ dysfunctions and their absence in GH, and also challenge the generally accepted view of abnormal placentation as the primary cause of preeclampsia. The striking similarity between abnormal maternal venous Doppler flow patterns and those observed at the ductus venosus and other abdominal veins of the intra-uterine growth restricted fetus, also invites to explore the role of venous congestion in the intra-uterine programming of some adult diseases.

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Correlations between pulmonary artery pressures and inferior vena cava collapsibility in critically ill surgical patients: An exploratory study

Cited by 8 publications

References 35 publications

Influence of the Respiratory Cycle on Caudal Vena Cava Diameter Measured by Sonography in Healthy Foals: A Pilot Study

Influence of the Respiratory Cycle on Caudal Vena Cava Diameter Measured by Sonography in Healthy Foals: A Pilot Study

Preeclampsia: a gestational cardiorenal syndrome

Maternal Venous Hemodynamic Dysfunction in Proteinuric Gestational Hypertension: Evidence and Implications

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