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The role of inferior vena cava diameter in volume status monitoring; the best sonographic measurement method?
Am J Emerg Med. 2015 Mar; 33(3):433-8.AJ

Abstract

OBJECTIVES

This study aims to determine the site of and the best sonographic method for measurement of inferior vena cava (IVC) diameter in volume status monitoring.

METHODS

This observational before-and-after study was performed at the intensive care unit of the emergency department. It included hypotensive adult patients with suspected sepsis who were recommended to receive at least 20 mg/kg fluid replacement by the emergency physician. The patients were fluid replaced at a rate of 1000 mL/h, and maximum and minimum IVC diameters were measured and the Caval index calculated sonographically via both B-mode and M-mode. Hence, IVC's volume response was assessed by a total of 6 parameters, 3 each in M-mode and B-mode. Freidman test was used to assess the change in IVC diameter with fluid replacement. Wilcoxon test with Bonferroni correction was used to determine which measurement method more sensitively measured IVC diameter change.

RESULTS

Twenty-eight patients with a mean age of 71.3 were included in the final analysis.The IVC diameter change was significant with all 6 methods (P < .001). The IVC minimum diameter change measured on M-mode during inspiration (M-mode i) was the only measurement method that significantly showed diameter change with each 500-mL fluid replacements. The initial and the subsequent M-mode i values after each 500 mL of fluid were 5.65 ± 3.34; 8.05 ± 3.66; 10.16 ± 3.61, and 11.21 ± 2.94, respectively (P < .001, P < .002, and P < .003, respectively).

CONCLUSION

Inferior vena cava diameter was changed by fluid administration. The M-mode i method that most sensitively measures that change may be the most successful method in volume status monitoring.

Authors+Show Affiliations

Beykoz State Hospital, Istanbul, Turkey.Haseki Training and Research Hospital, Istanbul, Turkey. Electronic address: adnanyaman29@gmail.com.İzmir Bozyaka Training and Research Hospital, Izmir, Turkey.İzmir Bozyaka Training and Research Hospital, Izmir, Turkey.Mehmet Akif Ersoy Training and Research Hospital, Şanlıurfa, Turkey.İzmir Bozyaka Training and Research Hospital, Izmir, Turkey.İzmir Bozyaka Training and Research Hospital, Izmir, Turkey.Marmara University, Istanbul, Turkey.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

25616587

Citation

Çelebi Yamanoğlu, Nalan Gökçe, et al. "The Role of Inferior Vena Cava Diameter in Volume Status Monitoring; the Best Sonographic Measurement Method?" The American Journal of Emergency Medicine, vol. 33, no. 3, 2015, pp. 433-8.
Çelebi Yamanoğlu NG, Yamanoğlu A, Parlak İ, et al. The role of inferior vena cava diameter in volume status monitoring; the best sonographic measurement method? Am J Emerg Med. 2015;33(3):433-8.
Çelebi Yamanoğlu, N. G., Yamanoğlu, A., Parlak, İ., Pınar, P., Tosun, A., Erkuran, B., Aydınok, G., & Torlak, F. (2015). The role of inferior vena cava diameter in volume status monitoring; the best sonographic measurement method? The American Journal of Emergency Medicine, 33(3), 433-8. https://doi.org/10.1016/j.ajem.2014.12.014
Çelebi Yamanoğlu NG, et al. The Role of Inferior Vena Cava Diameter in Volume Status Monitoring; the Best Sonographic Measurement Method. Am J Emerg Med. 2015;33(3):433-8. PubMed PMID: 25616587.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of inferior vena cava diameter in volume status monitoring; the best sonographic measurement method? AU - Çelebi Yamanoğlu,Nalan Gökçe, AU - Yamanoğlu,Adnan, AU - Parlak,İsmet, AU - Pınar,Pelin, AU - Tosun,Ali, AU - Erkuran,Burak, AU - Aydınok,Gizem, AU - Torlak,Fatih, Y1 - 2014/12/18/ PY - 2014/10/28/received PY - 2014/12/09/revised PY - 2014/12/09/accepted PY - 2015/1/25/entrez PY - 2015/1/27/pubmed PY - 2015/6/5/medline SP - 433 EP - 8 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 33 IS - 3 N2 - OBJECTIVES: This study aims to determine the site of and the best sonographic method for measurement of inferior vena cava (IVC) diameter in volume status monitoring. METHODS: This observational before-and-after study was performed at the intensive care unit of the emergency department. It included hypotensive adult patients with suspected sepsis who were recommended to receive at least 20 mg/kg fluid replacement by the emergency physician. The patients were fluid replaced at a rate of 1000 mL/h, and maximum and minimum IVC diameters were measured and the Caval index calculated sonographically via both B-mode and M-mode. Hence, IVC's volume response was assessed by a total of 6 parameters, 3 each in M-mode and B-mode. Freidman test was used to assess the change in IVC diameter with fluid replacement. Wilcoxon test with Bonferroni correction was used to determine which measurement method more sensitively measured IVC diameter change. RESULTS: Twenty-eight patients with a mean age of 71.3 were included in the final analysis.The IVC diameter change was significant with all 6 methods (P < .001). The IVC minimum diameter change measured on M-mode during inspiration (M-mode i) was the only measurement method that significantly showed diameter change with each 500-mL fluid replacements. The initial and the subsequent M-mode i values after each 500 mL of fluid were 5.65 ± 3.34; 8.05 ± 3.66; 10.16 ± 3.61, and 11.21 ± 2.94, respectively (P < .001, P < .002, and P < .003, respectively). CONCLUSION: Inferior vena cava diameter was changed by fluid administration. The M-mode i method that most sensitively measures that change may be the most successful method in volume status monitoring. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/25616587/The_role_of_inferior_vena_cava_diameter_in_volume_status_monitoring L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(14)00916-4 DB - PRIME DP - Unbound Medicine ER -