Difference between revisions of "IVC ultrasound"

(Redo and ref table)
Line 14: Line 14:
  
 
==Measurements==
 
==Measurements==
{| cellspacing="1" cellpadding="1" border="1" style="width: 300px;"
+
===Correlations Between IVC Size and CVP<ref>Goldflam K, et al. Focus on: Inferior vena cava ultrasound. ACEP News. June 2011.</ref>===
 +
{| class="wikitable"
 
|-
 
|-
| '''IVC'''
+
! IVC (cm) !! Respiratory Change !! CVP (cm H2O)
| '''&nbsp;% Collapse during inspiration^'''
 
| '''CVP'''
 
 
|-
 
|-
| &lt;1.5cm
+
| <1.5 || Total collapse || 0-5
| &gt;50%
 
| 0-5
 
 
|-
 
|-
| 1.5-2.5cm
+
| 1.5-2.5 || >50% collapse || 6-10
| &gt;50%  
 
| 5-10
 
 
|-
 
|-
| 1.5-2.5cm
+
| 1.5-2.5 || <50% collapse || 11-15
| &lt;50%  
 
| 10-15
 
 
|-
 
|-
| &gt;2.5cm
+
| >2.5 || <50% collapse || 16-20
| Little phasicity
+
|-
| 15-20
+
| >2.5 || No change || >20
 
|}
 
|}
 
+
''Measure 2cm from IVC/RA junction or 1cm from IVC/hepatic vein junction''
^Measure ~2cm from IVC/RA junction
 
 
 
*Can ask patient to sniff or valsalva to evaluate collapse
 
  
 
== See Also ==
 
== See Also ==

Revision as of 15:07, 7 March 2015

Background

  • Though contriversal, IVC measurement by ultrasound can estimate volume status and fluid responsiveness
    • There is moderate evidence to support that IVC diameter is consistently low in hypovolemia vs euvolemia[1]
    • It is suggested that IVC change can estimate fluid responsiveness with a Sn 0.78 and Sp 0.86[2]
  • Measure both absolute diameter of IVC and percent collapse during inspiration of spontaneously breathing patients
  • Can use as a dynamic assessment after intervention (giving fluids)
  • Unclear if applicable to intubated patients

Technique

  • Use curvilinear (abdominal) probe or phased array (cardiac) probe
  • In subxyphoid cardiac view (epigastric), fan probe laterally to view the IVC draining into the right atrium
    • may start with subxyphoid view, place right atrium in center of screen and rotate probe 90 degrees clockwise to find IVC
    • Use M-mode to measure IVC collapse during inspiration or estimation can be made in 2D with IVC in longitudinal axis

Measurements

Correlations Between IVC Size and CVP[3]

IVC (cm) Respiratory Change CVP (cm H2O)
<1.5 Total collapse 0-5
1.5-2.5 >50% collapse 6-10
1.5-2.5 <50% collapse 11-15
>2.5 <50% collapse 16-20
>2.5 No change >20

Measure 2cm from IVC/RA junction or 1cm from IVC/hepatic vein junction

See Also

References

Dawson, M. Mallin, M. Introduction To Bedside Ultrasound: Volumes 1 and 2.Emergency Ultrasound Solutions. 2012 Inkling File

  1. Dipti A, et al. Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. AJEM. 2012; 30:1414-1419.
  2. Zhang Z, et al. Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound Med Biol. 2014. May; 40(5):845-53.
  3. Goldflam K, et al. Focus on: Inferior vena cava ultrasound. ACEP News. June 2011.