Enhancement of Quality of Life with Adjustment of Dry Weight by Echocardiographic Measurement of Inferior Vena cava Diameter in Patients Undergoing Chronic Hemodialysis

Abstract Background and Aims The determination of dry weight (DW) in children on chronic hemodialysis (HD) remains problematic. No method has been shown superior for DW assessment in the few pediatric studies exploring the utility of inferior vena cava expiratory and inspiratory diameter diameter (IVCDe, IVCDi) and BIS against clinical criteria. We aimed to compare the performance of IVCD, BIS and clinical judgement in DW prediction in hemodialyzed children. Method IVCD and BIS were measured serially pre and post the midweek HD session. IVCDi, IVCDe and IVC contractility index (IVCCI) associations with: (1) BIS estimated (BIS-relOH) and (2) clinically assessed hydration status (OHc) based on deviation from DW were explored. The interpretation of IVC measurements was based on previously published pediatric reference values. The level of agreement between the three tools in fluid overload recognition was studied. Results Fifty-two sets of measurements were undertaken in 13 patients (median age 11 years). OHc and BIS-relOH were positively associated to each other (r=0,5, p<0,05) and to IVCDi (r=0,4, r=0,5, p<0,05) and IVCDe (r=0,4, r=0,6, p<0,05). A negative association between IVCCI and relOH-BIS was observed (r= -0,4, p<0,05). There was a poor agreement between the three methods in identification of fluid overload; out of 28 clinically overloaded patients, BIS identified only 7 whereas IVCD none (Cohen’s k <0). Conclusion IVCD measurements alone are not reliable for accurate fluid status prediction in hemodialyzed children as they seem to underestimate fluid overload compared to BIS and clinical criteria. Further studies are warranted to explore the applicability of new technologies for DW assessment of dialysis patients.

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The diaphragm affects echocardiographic measurement of inferior vena cava diameter to predict right atrial pressure

Journal of Medical Ultrasonics ◽

10.1007/s10396-020-01047-1 ◽

2020 ◽

Vol 47 (4) ◽

pp. 565-573

Author(s):

Yuichi Baba ◽

Juri Kawaguchi ◽

Yuri Ochi ◽

Daigo Hirakawa ◽

Takafumi Oryu ◽

...

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Atrial Pressure ◽

Right Atrial ◽

Right Atrial Pressure ◽

Echocardiographic Measurement ◽

Inferior Vena Cava Diameter

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Comparison of survival and quality of life of hepatectomy and thrombectomy using total hepatic vascular exclusion and chemotherapy alone in patients with hepatocellular carcinoma and tumor thrombi in the inferior vena cava and hepatic vein

European Journal of Gastroenterology & Hepatology ◽

10.1097/meg.0b013e32834dda64 ◽

2012 ◽

Vol 24 (2) ◽

pp. 186-194 ◽

Cited By ~ 17

Author(s):

Jianping Liu ◽

Yang Wang ◽

Dawei Zhang ◽

Bo Liu ◽

Qingjia Ou

Keyword(s):

Quality Of Life ◽

Hepatocellular Carcinoma ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Vascular Exclusion ◽

Total Hepatic Vascular Exclusion ◽

Hepatic Vascular Exclusion ◽

Tumor Thrombi

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Utility of the Inferior Vena Cava Diameter as a Marker of Dry Weight in Nonoliguric Hemodialyzed Patients

ASAIO Journal ◽

10.1097/00002480-200109000-00026 ◽

2001 ◽

Vol 47 (5) ◽

pp. 528-532 ◽

Cited By ~ 16

Author(s):

Satoru Yanagiba ◽

Yasuhiro Ando ◽

Eiji Kusano ◽

Yasushi Asano

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Dry Weight ◽

Inferior Vena Cava Diameter

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Nilai Diagnostik dan Peran Pemeriksaan Indeks Kolapsibilitas Diameter Vena Kava Inferior dalam Menilai Berat Kering pada Pasien Hemodialisis

Jurnal Penyakit Dalam Indonesia ◽

10.7454/jpdi.v3i2.14 ◽

2017 ◽

Vol 3 (2) ◽

pp. 88

Author(s):

Muhammad Artisto Adi Yussac ◽

Dharmeizar Dharmeizar ◽

Murdani Abdullah ◽

Dono Antono ◽

Muhadi Muhadi

Keyword(s):

Inferior Vena Cava ◽

Bioelectrical Impedance Analysis ◽

Inferior Vena ◽

Vena Cava ◽

Bioelectrical Impedance ◽

Dry Weight ◽

Impedance Analysis ◽

Collapsibility Index ◽

Weight Calculation ◽

Inferior Vena Cava Diameter

Pendahuluan. Dalam praktek klinis, status cairan pada pasien hemodialisis (HD) sangat berkaitan dengan berat kering. Penentuan berat kering yang dilakukan secara klinis tidak akurat sehingga diajukan berbagai metode untuk menilai berat kering secara noninvasif diantaranya yaitu pemeriksaan analisis bioimpedansi dan pemeriksaan indeks kolapsibilitas vena kava inferior. Penelitian ini dilakukan untuk mengetahui korelasi antara pengukuran indeks kolapsibilitas diameter vena kava inferior dan pemeriksaan analisis biompedansi. Sehingga, dapat diketahui peran pemeriksaan indeks kolapsibilitas vena kava inferior dalam mengevaluasi berat kering pada pasien dialisis.Metode. Studi potong lintang dilakukan di unit HD Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada bulan Juni 2011 dengan metode pengambilan sampel konsekutif. Berat kering dinilai dengan analisis bioimpedansi dan pemeriksaan indeks kolapsibilitas vena kava inferior dinilai dengan menggunakan USG.Hasil. Dari 30 subyek penelitian dengan rentang usia 24-69 tahun dan rerata 52 tahun , 18 (60%) subyek di antaranya mengalami kelebihan cairan menurut analisis bioimpedansi, sedangkan menurut pemeriksaan indeks kolapsibilitas vena kava inferior didapatkan 21 orang kelebihan cairan. . Terdapat korelasi negatif sedang antara pemeriksaan indeks kolapsibilitas diameter vena kava inferior dengan analisis bioimpedansi (r= -0,597, p<0,0001). Nilai sensitivitas dan spesifisitas untuk pemeriksaan indeks kolapsibilitas diameter vena kava inferior yaitu 94,4% dan 66,7%. Pada kedua operator USG didapatkan nilai κ (kappa) sebesar 0,92, artinya memiliki kesesuaian yang sangat kuat.Simpulan. Pemeriksaan indeks kolapsibilitas diameter vena kava inferior mempunyai peran sebagai alat skrining yang cukup baik dalam menilai berat kering pada pasien hemodialisis.Kata kunci: analisa bioimpedansi, berat kering, hemodialisis, indekskolapsibilitas vena kava inferior, korelasiDiagnostic Value and the Role of Inferior Vena Cava Diameter Collapsibility Index to Evaluate Dry Weight in Hemodialysis PatientsIntroduction. In daily clinical practice, fluid status in Hemodialysis (HD) patients is well correlated with dry weight calculation. Dry weight calculation is commonly practiced by clinical observation, which is not accurate. Because of these, few methods has been suggested to calculate the dry weight non-invasively. Bioelectrical Impedance Analysis (BIA) is widely available in overseas but not readily available in all dialysis center in Indonesia, while inferior vena cava diameter is a relatively inexpensive method, and readily available in all dialysis center because it can be performed with ultrasonography (USG) instrument. Methods. A cross-sectional study was performed in a group of regular HD patients at the Haemodialysis Unit, Cipto Mangunkusumo Hospital in Jakarta, June 2011. Dry weight was evaluated with bioelectrical impedance analysis, while the inferior vena cava collapsibility index was evaluated using USG performed by two different observer. Results. We have recruited 30 HD patients, in which 18 (60%) of the subjects were overload according to the bioelectrical impedance analysis, while 21 (70%) were overload according to the inferior vena cava collapsibility index. The mean age of the subjects is 52 years old with the minimum 24 and maximum 69 years. In this research, we found negative correlation (r = -0.957, P<0.0001) between inferior vena cava colapsibility index and BIA. We found a 94.4% sensitivity and 66.7% specificity for inferior vena cava colapsibility index. Both of USG operators showed a κ coefficient value of 0.92, which reflected a very strong agreement between them. Conclusions. The inferior vena cava colapsibility index have a good role as a screening method in determining dry weight in dialysis patients. Keywords: Hemodialysis, dry weight, bioelectrical impedance analysis, correlation, inferior vena cava colapsibility index.

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