Venous collapsibility index changes in children on dialysis

Haciomeroglu, Pelin; Özkaya, Ozan; Günal, Nazlıhan; Baysal, Kemal

doi:10.1111/j.1440-1797.2006.00700.x

Cited by 30 publications

(24 citation statements)

References 17 publications

(38 reference statements)

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“…In septic passively ventilated patients, respirophasic SVC diameter changes appear to correlate well with CO responsiveness to iv fluid [59]. The SVC index of hypovolemia has been advocated as superior to that based on IVC diameter [60]. In contrast to the IVC which can be easily seen through a subcostal view, the SVC requires imaging via the transesophageal route.…”

Section: Venous Side Approachmentioning

confidence: 98%

“…This tends to reduce the IVC diameter providing the vessel operates on the steep rather than the plateau part of its transmural pressure/diameter relationship. Quantified in various ways with echocardiography, the IVC diameter has been used to characterize volume status in the course of hemodialysis for end-stage renal disease [55,60]. Prediction of fluid responsiveness in spontaneously breathing ICU subjects using this approach has not been validated to our knowledge.…”

Section: Venous Side Approachmentioning

confidence: 99%

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Cardiopulmonary interactions and volume status assessment

Broccard

2012

J Clin Monit Comput

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Assessment of the hemodynamics and volume status is an important daily task for physicians caring for critically ill patients. There is growing consensus in the critical care community that the "traditional" methods-e.g., central venous pressure or pulmonary artery occlusion pressure-used to assess volume status and fluid responsiveness are not well supported by evidence and can be misleading. Our purpose is to provide here an overview of the knowledge needed by ICU physicians to take advantage of mechanical cardiopulmonary interactions to assess volume responsiveness. Although not perfect, such dynamic assessment of fluid responsiveness can be helpful particularly in the passively ventilated patients. We discuss the impact of phasic changes in lung volume and intrathoracic pressure on the pulmonary and systemic circulation and on the heart function. We review how respirophasic changes on the venous side (great veins geometry) and arterial side (e.g., stroke volume/systolic blood pressure and surrogate signals) can be used to detect fluid responsiveness or hemodynamic alterations commonly encountered in the ICU. We review the physiological limitations of this approach.

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Section: Venous Side Approachmentioning

confidence: 98%

Section: Venous Side Approachmentioning

confidence: 99%

Cardiopulmonary interactions and volume status assessment

Broccard

2012

J Clin Monit Comput

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“…Pediatric data on this technique are sparse, with one study demonstrating improvement in IVC collapsibility index following ultrafiltration in 16 children on peritoneal dialysis (PD) and 9 on hemodialysis (HD) [16]. …”

Section: Assessment Of Fluid Overloadmentioning

confidence: 99%

Assessment and management of fluid overload in children on dialysis

Hayes

Paglialonga

2018

Pediatr Nephrol

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Dysregulation of intravascular fluid leads to chronic volume overload in children with end-stage kidney disease (ESKD). Sequelae include left ventricular hypertrophy and remodeling and impaired cardiac function. As a result, cardiovascular complications are the commonest cause of mortality in the pediatric dialysis population. The clinical need to optimize intravascular volume in children with ESKD is clear; however, its assessment and management is the most challenging aspect of the pediatric dialysis prescription. Minimizing chronic fluid overload is a key priority; however, excessive ultrafiltration is toxic to the myocardium and can precipitate intradialytic symptoms. This review outlines emerging objective techniques to enhance the assessment of fluid overload in children on dialysis and outlines evidence for current management strategies to address this clinical problem.

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“…Thus, one would expect that phasic changes in transmural pressure would more readily translate into respiratory variations in cross-sectional size when imposed on a partially empty vessel (hypovolemia), as opposed to a fully repleted one (normo or hypervolemia). Based on this rationale, the phasic changes in caval diameters, as evaluated from echocardiography, have been proposed as non-invasive indices of intravascular volume status [44][45][46][47][48][49][50].…”

Section: Respiratory Fluctuations Of Great Veins Geometrymentioning

confidence: 99%

“…The latter, however, only causes the IVC diameter to shrink if the vessel is not fully repleted (i.e., if it operates on the steep part rather than the plateau of its transmural pressure/ diameter relationship). Quantified in various ways with transthoracic echocardiography, the inspiratory decrease of IVC diameter has been used to characterize volume status in the course of hemodialysis for end-stage renal disease [45,46]. In the ICU, we are aware of no similar application in spontaneously breathing subjects.…”

Section: Respiratory Fluctuations Of Great Veins Geometrymentioning

confidence: 99%

Interactions between respiration and systemic hemodynamics. Part II: practical implications in critical care

Feihl

Broccard

2008

Intensive Care Med

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In Part I of this review, we have covered basic concepts regarding cardiorespiratory interactions. Here, we put this theoretical framework to practical use. We describe mechanisms underlying Kussmaul's sign and pulsus paradoxus. We review the literature on the use of respiratory variations of blood pressure to evaluate volume status. We show the possibilities of attaining the latter aim by investigating with ultrasonography how the geometry of great veins fluctuates with respiration.

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Venous collapsibility index changes in children on dialysis

Abstract: We suggest that serial measurements of CI in children will be a useful guide to assess the volume changes in an individual instead of a single measurement.

Cited by 30 publications

References 17 publications

Cardiopulmonary interactions and volume status assessment

Cardiopulmonary interactions and volume status assessment

Assessment and management of fluid overload in children on dialysis

Interactions between respiration and systemic hemodynamics. Part II: practical implications in critical care

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