scholarly journals Sonographic Estimation Rather Than Quantification of Fluid Status Using Inferior Vena Cava and Other Major Vessel Parameters in a Non-Bleeding Fluid Loss and Centralization Model

2021 ◽  
Vol Volume 13 ◽  
pp. 391-398
Author(s):  
Andreas Fichtner ◽  
Benedikt Brunner ◽  
Enrico Kloemich ◽  
Thomas Grab ◽  
Thomas Pohl ◽  
...  
2012 ◽  
Vol 78 (4) ◽  
pp. 468-470 ◽  
Author(s):  
Paula Ferrada ◽  
Rahul J. Anand ◽  
James Whelan ◽  
Michel A. Aboutanos ◽  
Therese Duane ◽  
...  

Inferior vena cava (IVC) diameter change on limited transthoracic echocardiogram (LTTE) can provide a useful guide of fluid status evaluation in critically ill patients. Institutional review board approval was obtained. Prospective evaluation of hemodynamic status was performed in hypotensive patients via LTTE. Images were obtained using an ultrasound machine without M-mode capability. Qualitative assessment of the IVC was obtained via subxyphoid window. FLAT IVC was defined as diameter less than 2 cm and FAT IVC when the vein was equal or larger than 2 cm. Collapsibility was assessed by observing respiratory variation of the vessel. Lactate was measured before and after therapy was initiated. A follow-up LTTE was obtained after fluid challenge. A total of 108 LTTE were performed. Patients’ age ranged from 18 to 89 years with an average of 53. Admission diagnosis was blunt trauma in 66 patients, penetrating trauma in 17, whereas 25 had nontraumatic intra-abdominal emergency. Sixty-nine patients were receiving mechanical ventilation at time of LTTE. Seventy-three patients had a FLAT IVC, and received fluid challenge as therapy. All patients had a change in IVC volume from “FLAT” to “FAT” after the fluid challenge. Seventy-one patients (97%) had resolution of hypotension after the first fluid challenge. Two patients had persistent hypotension and received a second fluid challenge. Follow-up LTTE demonstrated a FAT IVC and lack of collapsibility. Lactate decreased in all 73 patients after therapy guided by LTTE ( P < 0.00001) Evaluation of the IVC diameter via LTTE offers a rapid, non invasive way to evaluate fluid status in critically ill patients.


2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Xavier Torterüe ◽  
Laurène Dehoux ◽  
Marie-Alice Macher ◽  
Olivier Niel ◽  
Thérésa Kwon ◽  
...  

2017 ◽  
Vol 22 (2) ◽  
pp. 261-269 ◽  
Author(s):  
Ulrich Steinwandel ◽  
Nicholas Gibson ◽  
Amanda Towell ◽  
James J. R. Rippey ◽  
Johan Rosman

Author(s):  
Tomas Zaoral ◽  
Peter Kordos ◽  
Marketa Nowakova ◽  
Borek Travnicek ◽  
Jana Zapletalova ◽  
...  

Abstract Purpose To determine normative data for the inferior vena cava (VCI) diameter in euvolemic children and its correlation with different somatic parameters in a pediatric population at one center in Europe. Materials and Methods This prospective observational study enrolled healthy children aged 4 weeks to 18y that visited our outpatient clinic. Weight, height, body surface area, and age were recorded. The children were grouped according to weight, as follows (80 children/group): < 10 kg, 10–19.9 kg, 20–29.9 kg, 30–59.9 kg, and 60–90 kg. Children were placed in a supine position and, during quiet respiration, the maximum and minimum VCI diameters were measured with M-mode ultrasonography. The collapsibility index (CI) was also automatically calculated for each subject: CI = [VCI maximum (expiratory) diameter – VCI minimum (inspiratory) diameter]/VCI maximum (expiratory) diameter. Results From May 2016 through November 2018 we retrieved data for 415 children that underwent VCI diameter evaluations. 400 children were included (mean age: 7.8y ± 5.8, mean weight: 32 kg ± 24.4, 46 % girls). The VCImax and the VCImin were significantly correlated with age (r = 0.867, p < 0.001, r = 0.797, p < 0.001), height (r = 0.840, p < 0.001, r = 0.772, p < 0.001), weight (r = 0.858, p < 0.001, r = 0.809, p < 0.001), and BSA (r = 0.878, p < 0.001, r = 0.817, p < 0.001). Correlations between the CI and age, weight, height, and BSA were not statistically significant. Conclusion This prospective study provided reference values for sonographic measurements of VCI diameters in euvolemic children and might greatly assist in assessing fluid status in sick children.


2016 ◽  
Vol 24 (3) ◽  
pp. 409-412 ◽  
Author(s):  
Dai Ariyoshi ◽  
Shigeo Sano ◽  
Naohiro Kawamura

Anterior dislodgement of the transforaminal lumbar interbody fusion (TLIF) cage is one of the severe complications seen in this procedure, which may cause an intraoperative major vessel injury. The objective of this report is to present a rare case of inferior vena cava (IVC) injury during revision surgery for removal of the anteriorly migrated cage. The authors describe a case of 74-year-old woman with lumbar spinal canal stenosis and degenerative scoliosis. During the TLIF surgery, an inserted titanium cage at the L4–5 level dislodged anteriorly to the retroperitoneal space without massive bleeding from the disc space. In the second surgery, which was performed via an anterior retroperitoneal approach to remove the migrated cage, massive torrential bleeding occurred because of IVC injury. The laceration in the posterior wall of the IVC necessitated ligation of this vessel and both common iliac veins by a vascular surgeon. Postoperative edema of the lower extremities after ligation of the vessels was well tolerated, and the patient showed almost full recovery. For removal surgery of an anteriorly migrated cage, the surgeon should be well prepared for the risk of IVC injury, including requesting the attendance of a vascular surgeon. Ligation of the infrarenal IVC is an acceptable solution in irreparable IVC injury.


2001 ◽  
Vol 16 (6) ◽  
pp. 1203-1206 ◽  
Author(s):  
Irit Krause ◽  
Einat Birk ◽  
Miriam Davidovits ◽  
Roxana Cleper ◽  
Leonard Blieden ◽  
...  

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