SAT-097-Non-invasive estimation of intravascular volume status in cirrhosis by dynamic size and collapsibility Indices of the inferior vena cava using bedside echocardiography

2019 ◽  
Vol 70 (1) ◽  
pp. e670-e671
Author(s):  
Madhumita Premkumar ◽  
Devaraja Rangegowda ◽  
Kamal Kajal ◽  
Jelen Khumuckham
2019 ◽  
Vol 28 (11-12) ◽  
pp. 2135-2146 ◽  
Author(s):  
Ulrich Steinwandel ◽  
Nick Gibson ◽  
Amanda Towell‐Barnard ◽  
Richard Parsons ◽  
James Rippey ◽  
...  

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Samaa A Kasem ◽  
Ahmed Goda Ahmed ◽  
Hebattallah Nagm Eldeen ◽  
Dina Y Kassim

Background: This study aimed to assess the correlation between the internal jugular vein/common carotid artery (IJV/CCA) cross-sectional area (CSA) ratio and the inferior vena cava (IVC) diameter as non-invasive techniques for the assessment of intravascular volume. Methods: The study samples included 35 adult patients of both sexes (age range: 20 - 60 years) according to the criteria of the American Society of Anaesthesiology (ASA) physical status II - III, who were admitted to the surgical intensive care unit (SICU) after major surgeries for the assessment of intravascular volume status. Results: There was a positive correlation between the IJV/CCA CSA ratio and the IVC maximum and minimum diameter before and after fluid infusion (r = 0.923, P < 0.001 and r = 0.390, P = 0.021, respectively) and between the IJV/CCA CSA ratio at inspiration and the IVC minimum diameter before and after fluid infusion (r = 0.605, P < 0.001 and r = 0.496, P < 0.001, respectively). The sensitivity and specificity analysis of the IJV/CCA CSA during inspiration after fluid correction to predict a central venous pressure (CVP) of 8 - 12 cmH2O showed that at a ratio of 2.56, the highest sensitivity was 56.5%, and the specificity was 83.3%; at a ratio of 2.58, the highest sensitivity was 65.2% and the specificity was 75%. During expiration, specificity after fluid correction was 56.62%; at a ratio of 2.62, the highest sensitivity was 52.2%, and the specificity was 67%; and at a ratio of 2.65, the sensitivity was 56.5%, and the specificity was 50%. Conclusions: The assessment of the IJV/CCA CSA ratio alongside ultrasonography could be a non-invasive tool for the evaluation of intravascular volume status in spontaneously breathing adult patients after major surgeries.


2021 ◽  
Author(s):  
Hanan El-Halaby ◽  
Ashraf Bakr ◽  
Mohamed El-Assmy ◽  
Hussein Abdelaziz Abdalla ◽  
Marwa Salem ◽  
...  

Abstract Evaluating the volume status in children with Idiopathic nephrotic syndrome (INS) is mandatory to guide treatment and avoid unnecessary possibly hazardous albumin use. This study aimed to evaluate and compare the available tools used for volume status assessment and differentiating type of edema in children with INS. Sixty children with active INS were included and subdivided into hypovolemic and non-hypovolemic groups based on fractional excretion of sodium (FeNa%) and clinical assessment. All patients were studied for Inferior vena cava collapsibility index (IVCCI), plasma atrial natriuretic peptide (ANP) concentration and Body composition monitor (BCM). Forty-four patients (77.3%) had non-hypovolemic and 16 (26.7%) had hypovolemic states. Plasma ANP levels didn’t differ between hypovolemic and non-hypovolemic subgroups. IVCCI was higher in hypovolemic group (p<0.001) with sensitivity 87.5% and specificity 81.8% for hypovolemia detection while BCM-over hydration (BCM-OH) values were higher in non-hypovolemic group (p=0.04) with sensitivity= 68.2% and specificity =75% for detection of hypervolemia. FeNa% showed negative significant correlation with IVCCI (r= -0.578, p <0.001) and positive significant correlation with BCM-OH (r= 0.33, p=0.018), while FeNa% showed non-significant correlation to plasma ANP concentration (p=0.25). Conclusion: Non-hypovolemic edema is more frequent in edematous INS children than hypovolemic states. IVCCI is a reliable non-invasive bedside tool for evaluating volume status in INS children and is superior to BCM while plasma ANP levels can’t discriminate type of edema in INS.


Electronics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 1671
Author(s):  
Luca Mesin ◽  
Silvestro Roatta ◽  
Paolo Pasquero ◽  
Massimo Porta

Assessment of volume status is important to correctly plan the treatment of patients admitted and managed by cardiology, emergency and internal medicine departments. Non-invasive assessment of volume status by echography of the inferior vena cava (IVC) is a promising possibility, but its clinical use is limited by poor reproducibility of current standard procedures. We have developed new algorithms to extract reliable information from non-invasive IVC monitoring by ultrasound (US) imaging. Both long and short axis US B-mode video-clips were taken from 50 patients, in either hypo-, eu-, or hyper-volemic conditions. The video-clips were processed to extract static and dynamic indexes characterizing the IVC behaviour. Different binary tree models (BTM) were developed to identify patient conditions on the basis of those indexes. The best classifier was a BTM using IVC pulsatility indexes as input features. Its accuracy (78.0% when tested with a leave-one-out approach) is superior to that achieved using indexes measured by the standard clinical method from M-mode US recordings. These results were obtained with patients in conditions of normal respiratory function and cardiac rhythm. Further studies are necessary to extend this approach to patients with more complex cardio-respiratory conditions.


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