Relationship between inferior vena cava diameter ratio and central venous pressure

Zhang, Qing; Wang, Xiaoting; Su, Longxiang; Zhang, Hongmin; Chai, Weidong; Chao, Yangong; He, Wei

doi:10.1002/jcu.22586

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…These patients are immobile and have no muscular contraction and no or very little muscular tone; therefore, venous return is extremely impaired. The half-seated position used in mechanically ventilated patients to improve ventilation parameters introduces another obstacle to venous return, depending on the angle between lower limbs and the body (Zhang et al, 2018), decreasing the blood flow velocity of the venous return and increasing the diameter of the lower limb veins due to venous pooling.…”

Section: Hemorrheologic Factors Favoring Thrombosismentioning

confidence: 99%

Pathophysiological Processes Underlying the High Prevalence of Deep Vein Thrombosis in Critically Ill COVID-19 Patients

et al. 2021

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Coronavirus disease 2019 (COVID-19) predisposes to deep vein thrombosis (DVT) and pulmonary embolism (PE) particularly in mechanically ventilated adults with severe pneumonia. The extremely high prevalence of DVT in the COVID-19 patients hospitalized in the intensive care unit (ICU) has been established between 25 and 84% based on studies including systematic duplex ultrasound of the lower limbs when prophylactic anticoagulation was systematically administrated. DVT prevalence has been shown to be markedly higher than in mechanically ventilated influenza patients (6–8%). Unusually high inflammatory and prothrombotic phenotype represents a striking feature of COVID-19 patients, as reflected by markedly elevated reactive protein C, fibrinogen, interleukin 6, von Willebrand factor, and factor VIII. Moreover, in critically ill patients, venous stasis has been associated with the prothrombotic phenotype attributed to COVID-19, which increases the risk of thrombosis. Venous stasis results among others from immobilization under muscular paralysis, mechanical ventilation with high positive end-expiratory pressure, and pulmonary microvascular network injuries or occlusions. Venous return to the heart is subsequently decreased with increase in central and peripheral venous pressures, marked proximal and distal veins dilation, and drops in venous blood flow velocities, leading to a spontaneous contrast “sludge pattern” in veins considered as prothrombotic. Together with endothelial lesions and hypercoagulability status, venous stasis completes the Virchow triad and considerably increases the prevalence of DVT and PE in critically ill COVID-19 patients, therefore raising questions regarding the optimal doses for thromboprophylaxis during ICU stay.

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Section: Hemorrheologic Factors Favoring Thrombosismentioning

confidence: 99%

Pathophysiological Processes Underlying the High Prevalence of Deep Vein Thrombosis in Critically Ill COVID-19 Patients

et al. 2021

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“…9 At this point, even if the LV that cardiac function and venous return do not match. 10 In daily practice, echocardiography and lung ultrasound cannot be performed.…”

Section: Discussionmentioning

confidence: 99%

“…At this point, even if the LV ejection fraction is normal, cardiac output still cannot meet the needs of maintaining blood pressure and tissue perfusion. IVC dilatation and fixation are associated with high central venous pressure, suggesting that cardiac function and venous return do not match 10 . In daily practice, echocardiography and lung ultrasound cannot be performed.…”

Section: Discussionmentioning

confidence: 99%

Bedside critical ultrasound as a key to the diagnosis of obstructive atelectasis complicated with acute cor pulmonale and differentiation from pulmonary embolism: A case report

Zhao

Yan

Liu

et al. 2022

J of Clinical Ultrasound

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Acute attack of dyspnea may be combined with acute cor pulmonale (ACP). Rapid and accurate identification of the etiology of ACP is the key to its diagnosis and treatment. Echocardiography is a better imaging tool in the assessment of right ventricular function. Under the guidance of the theory of cardiopulmonary interaction, ultrasonography can detect lung lesions, which causes ACP. We report the case of a 67‐year‐old man who received mechanical ventilation for acute respiratory failure. Right ventricular dysfunction was detected by echocardiography. Lung ultrasound showed a high risk of pulmonary embolism. However, obstructive atelectasis should not be ruled out after increasing back area ultrasonography. To avoid pitfalls, combined cardiac and lung ultrasound should be used carefully and strictly.

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“…For ventilated patients, an IVC diameter of ≤12 mm often indicates that the right atrial pressure is not greater than 10 mmHg [15]. Zhang et al found the ratio of transverse maximum and minimum IVC diameter greater than 1.7 can predict CVP less than 8 mmHg [16]. When assessing right atrial pressure by IVC ultrasound measurement, it is crucial to consider the impact of factors like mechanical ventilation, intra-abdominal pressure, and pericardial effusion.…”

Section: Heartmentioning

confidence: 99%

Assessment of Pulmonary Circulation of Critically Ill Patients Based on Critical Care Ultrasound

Gong,

Ding,

Wang

2024

JCM

Self Cite

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Pulmonary circulation is crucial in the human circulatory system, facilitating the oxygenation of blood as it moves from the right heart to the lungs and then to the left heart. However, during critical illness, pulmonary microcirculation can be vulnerable to both intrapulmonary and extrapulmonary injuries. To assess these potential injuries in critically ill patients, critical point-of-care ultrasound can be used to quantitatively and qualitatively evaluate the right atrium, right ventricle, pulmonary artery, lung, pulmonary vein, and left atrium along the direction of blood flow. This assessment is particularly valuable for common ICU diseases such as acute respiratory distress syndrome (ARDS), sepsis, pulmonary hypertension, and cardiogenic pulmonary edema. It has significant potential for diagnosing and treating these conditions in critical care medicine.

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Relationship between inferior vena cava diameter ratio and central venous pressure

Abstract: DR above 1.7 is predictive of CVP < 8 mm Hg.

Cited by 5 publications

References 14 publications

Pathophysiological Processes Underlying the High Prevalence of Deep Vein Thrombosis in Critically Ill COVID-19 Patients

Pathophysiological Processes Underlying the High Prevalence of Deep Vein Thrombosis in Critically Ill COVID-19 Patients

Bedside critical ultrasound as a key to the diagnosis of obstructive atelectasis complicated with acute cor pulmonale and differentiation from pulmonary embolism: A case report

Assessment of Pulmonary Circulation of Critically Ill Patients Based on Critical Care Ultrasound

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