Inferior vena cava obstruction and shock

Megri, Mohammed; Elhamdani, Shaheed; Abusnina, Waiel; Al-dliw, Majdi; Yousef, Shweihat

doi:10.4103/jets.jets_22_17

Cited by 7 publications

(10 citation statements)

References 14 publications

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“…CVP and shock index are adopted in isolation to guide emergency rescue of patients with traumatic shock. It is not recommended in recent national and international guidelines for trauma diagnosis and treatment [11][12][13][14]. While bedside ultrasound examination, the use time of collecting each index of inferior vena cava diameter is much shorter than other invasive Note: There exhibited no significant difference between two groups (P > 0:05).…”

Section: Discussionmentioning

confidence: 99%

Application Value of Emergency Bedside Echocardiography in Early Warning of Acute and Severe Shock and Clinical Classification

Yang

Chen

2022

Computational and Mathematical Methods in Medicine

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Objective. A case-control study was conducted to explore the application value of emergency bedside echocardiography in early warning of acute and severe shock and clinical classification. Methods. A total of 135 critically ill patients admitted to ICU from August 2019 to November 2020 were divided into shock group ( n = 53 ) and nonshock group ( n = 82 ) according to the occurrence of shock. The internal diameter index of inferior vena cava was measured and recorded by bedside ultrasound in patients with shock before and after treatment and in patients without shock. Shock index and inferior vena cava diameter deformation index (SCI) were calculated according to the results. The diagnostic time and curative effect of different ultrasonic examination methods for the types of shock were compared and analyzed. Results. At admission, the maximum and minimum ventilation of inferior vena cava in patients without shock were higher than those in the shock group, and the internal diameter deformation index of inferior vena cava in the shock group was higher than that in the shock group ( P < 0.05 ). In the shock group, IVCmax and IVCmin before and after treatment were higher than those before resuscitation, while SCI was lower than that before resuscitation. The results of ROC curve analysis showed that SCI and IVCmin were significantly better than IVCmax and IVCmin in predicting shock area and slightly better than IVCmin. There was significant difference in diagnosis time between the two groups ( P < 0.05 ). The specificity, positive predictive value, and negative predictive value of emergency ultrasound diagnosis were lower than those of clinical diagnosis ( P < 0.05 ). The sensitivity, specificity, positive predictive value, and negative predictive value of emergency ultrasound diagnosis were lower than those of clinical diagnosis ( P < 0.05 ). The sensitivity and positive predictive value of the emergency ultrasound group were higher than those of the routine ultrasound group ( P < 0.05 ). The diagnosis rate of shock type AUC in the emergency ultrasound group was 0.854, and the diagnostic value was high. Conclusion. IVCmax, IVCmin, and SCI obtained by bedside ultrasound have certain clinical significance for the diagnosis and treatment of shock. Emergency bedside ultrasound examination and measurement of shock patients are helpful to quickly evaluate and identify the types of early shock.

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Section: Discussionmentioning

confidence: 99%

Application Value of Emergency Bedside Echocardiography in Early Warning of Acute and Severe Shock and Clinical Classification

Yang

Chen

2022

Computational and Mathematical Methods in Medicine

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“…The management of obstructive shock secondary to inferior vena cava obstruction depends on the chronicity of thrombosis and other associated complications. In most cases, patients can be successfully relieved through anticoagulation therapy, catheter-guided thrombolysis, or thrombectomy, as reported in the literature [6,14,15]. In the present case, we performed catheter-directed thrombus aspiration to relieve the IVC obstruction, leading to an immediate recovery of blood pressure and subsequent restoration of urine output (Figure 1).…”

Section: Discussionmentioning

confidence: 60%

“…Subsequently, acute iliac venous system thrombosis occurred [13]. Thrombus aspiration was employed in three cases [6,13,16], and catheter-directed thrombolysis (CDT) was used in one case [13].…”

Section: Discussionmentioning

confidence: 99%

Acute Caval Thrombosis Leading to Obstructive Shock in the Early Post Insertion Period of an Inferior Vena Cava Filter ： A Case Report and Literature Review

Gao,

Chen,

Huang

et al. 2023

Preprint

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Background Obstructive shock is extremely rare in clinical practice and is caused by acute blood flow obstruction in the central vessels of either the systemic or pulmonary circulation. Utilizing inferior vena cava filters (IVCFs) to prevent pulmonary embolism (PE) is associated with some potential complications, such as inferior vena cava thrombosis (IVCT). Shock as a direct result of IVCT is rare. We present a case of obstructive shock secondary to extensive IVCT caused by inadequate anticoagulant therapy after the placement of an IVCF. Case presentation: A 63-year-old male patient with a traffic accident injury presented orthopaedic trauma and lower limb deep vein thrombosis (DVT). He experienced sudden and severe abdominal pain with hypotension, tachycardia, tachypnea, oliguria and peripheral oedema 5 days after IVCF placement and 3 days after cessation of anticoagulant therapy. Considering that empirical anti-shock treatment lasted for a while and the curative effect was poor, we finally recognized the affected vessels and focused on the reason for obstructive shock through imaging findings—inferior vena cava thrombosis and occlusion. The shock state immediately resolved after thrombus aspiration. The same type of shock occurred again 6 days later during transfer from the ICU to general wards and the same treatment was administered. The patient recovered smoothly in the later stage, and the postoperative follow-up at 1, 3, and 12 months showed good results. Conclusion This case alerts clinicians that it is crucial to ensure adequate anticoagulation therapy after IVCF placement, and when a patient presents with symptoms such as hypotension, tachycardia, and lower limb and scrotal oedema postoperatively, immediate consideration should be given to the possibility of obstructive shock, and prompt intervention should be based on the underlying cause.

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“…The symptoms of IVC obstruction are depend upon the level of obstruction and they include intravascular hypovolemia, liver damage, kidney damage, edema of lower extremities, and ileus. In rare occasions, intravascular hypovolemia caused by IVC obstruction induces circulation collapse and result in shock, a life-threatening condition (Mohammed et al, 2018). The treatments of IVC obstruction are varied according to the cause of IVC obstruction.…”

Section: Discussionmentioning

confidence: 99%

Inferior vena cava syndrome caused by retroperitoneal fibrosis after pelvic irradiation: A case report

Murakami

Takagawa

Okuma

et al. 2019

Gynecologic Oncology Reports

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In this case report, we share our experience of a case with inferior vena cava (IVC) syndrome caused by secondary retroperitoneal fibrosis related to prior pelvic irradiation. A 60 year-old-female who has history of pelvic irradiation developed severe leg edema. Radiological examination revealed obstruction of IVC. Soon after recanalization of IVC with metallic stent placement, her symptom relieved.

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Inferior vena cava obstruction and shock

Cited by 7 publications

References 14 publications

Application Value of Emergency Bedside Echocardiography in Early Warning of Acute and Severe Shock and Clinical Classification

Application Value of Emergency Bedside Echocardiography in Early Warning of Acute and Severe Shock and Clinical Classification

Acute Caval Thrombosis Leading to Obstructive Shock in the Early Post Insertion Period of an Inferior Vena Cava Filter ： A Case Report and Literature Review

Inferior vena cava syndrome caused by retroperitoneal fibrosis after pelvic irradiation: A case report

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