MEASUREMENT OF INFERIOR VENA CAVA DIAMETER BY ULTRASOUND IN INTENSIVE CARE UNIT PATIENTS WITH PNEUMONIA

The frequency of insertion of prophylactic inferior vena cava filters (IVCF) among traumatized patients has increased nationally. That has placed a substantial operational and economic burden upon trauma centers. The purpose of this study was to compare and contrast successful implantation, morbidity, and cost-effectiveness of prophylactic IVCF insertion in a surgical-trauma intensive care unit (STICU) versus an operating room (OR). A retrospective chart review was conducted of all trauma patients who received a prophylactic IVCF at an urban Level I trauma center between January 1999 and December 2003. Data were collected to identify patient demographics, indications, anatomical site of insertion, hospital location of insertion, hospital days before insertion, and complications associated with insertion. One hundred thirty-four patients underwent prophylactic IVCF during the study period: seventy-eight (58%) in the OR and fifty-six (42%) in the STICU. The average age of patients for the OR and STICU groups were 38.6 years and 39.6 years, respectively. The average number of days to IVCF insertion was 6.5 days and 7.0 days in the OR and STICU groups, respectively. Indications for IVCF among patients who had placement in the OR were orthopedic injury (60%), spinal cord injury (25%), and head injury (15%). Indications for IVCF among patients who had placement in the STICU were head injury (38%), orthopedic injuries (34%), and spinal cord injury (25%). Three (3.8%) patients in the OR group and two (3.6%) patients in the STICU group required a change of anatomic insertion site from the femoral to the internal jugular vein. There were two (2.6%) complications associated with IVCF insertion in the OR and two (3.5%) complications associated with IVCF insertion in the STICU (P > 0.05). Insertion of IVCF in the STICU decreased patient-cost by an average of $1636 per patient. Prophylactic IVCF insertion in an STICU is cost-effective and can be performed with similar success and complication rates to IVCF insertion in an OR.

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Central venous pressure correlates with inferior vena cava collapsibility index in patients treated in intensive care unit

Bali Journal of Anesthesiology ◽

10.15562/bjoa.v1i1.2 ◽

2017 ◽

Vol 1 (1) ◽

pp. 7

Author(s):

EmkelPerangin Angin ◽

Made Wiryana ◽

IKetut Sinardja ◽

IWayan Aryabiantara ◽

TjokordaGdeAgung Senapathi ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Inferior Vena Cava ◽

Central Venous Pressure ◽

Inferior Vena ◽

Venous Pressure ◽

Vena Cava ◽

Central Venous ◽

Collapsibility Index

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Ultrasound Evaluation of the Respiratory Variations of the Internal Jugular Vein Compared to the Respiratory Variations of the Inferior Vena Cava as a Guidance of Fluid Responsiveness in Septic Shock

QJM ◽

10.1093/qjmed/hcab086.003 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Abd Elalim Ali Khalil ◽

. Galal Adel Mohamed Elkadi ◽

Sherif George Anies Saeid ◽

Gamal Eldin Adel Abd Elhameed Saleh

Keyword(s):

Intensive Care Unit ◽

Septic Shock ◽

Intensive Care ◽

Inferior Vena Cava ◽

Fluid Responsiveness ◽

Internal Jugular Vein ◽

Fluid Resuscitation ◽

Inferior Vena ◽

Jugular Vein ◽

Vena Cava

Abstract Background Septic shock is one of the most complex hemodynamic failure syndromes. It is the major cause of mortality and morbidity in intensive care unit. Fluid resuscitation is of paramount importance in septic shock. However, its correction should be carefully guided to avoid unnecessary volume expansion. Ultra- sonographic evaluation of fluid responsiveness plays an important role in septic shock. Objectives The objective of the study was to verify the feasibility and usefulness of the internal jugular vein distensibility index in prediction of fluid responsiveness in septic shock patients undergoing mechanical ventilation compared to the inferior vena cava distensibility index. Methodology The study was carried out in Ain Shams University Hospital from February 2019 to November 2019, on twenty patients 20 patients of both sex who were admitted to the intensive care unit and diagnosed as septic shock (sepsisinduced hypotension persisting despite adequate fluid resuscitation and require vasopressors and serum lactate > 2 mmol/ L) As regard the hemodynamic parameters, patients were classified into two groups: Fluid responders and non-fluid responders. Results The study demonstrated that there was a positive correlation between internal jugular vein distensibility index (IJV DI) and inferior vena cava distensibility index (IVC DI) in prediction of fluid responsiveness. IVC DI index cutoff value was > 12.6% with sensitivity 80% and specificity 80% and IJV DI cut off value was >8.4% with sensitivity 86.67% and specificity 80%. Conclusion ultra-sonographic assessment of the internal jugular vein distensibility index (IJV DI) and inferior vena cava distensibility index (IVC DI) are useful dynamic indices in assessment of the intravascular volume state in mechanically ventilated septic shock patients. IJV and IVC show comparable value in the prediction of fluid responsiveness.

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Flat Inferior Vena Cava: Indicator of Poor Prognosis in Trauma and Acute Care Surgery Patients

The American Surgeon ◽

10.1177/000313481207801234 ◽

2012 ◽

Vol 78 (12) ◽

pp. 1396-1398 ◽

Cited By ~ 14

Author(s):

Paula Ferrada ◽

Poornima Vanguri ◽

Rahul J. Anand ◽

James Whelan ◽

Therese Duane ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Blood Transfusion ◽

Inferior Vena Cava ◽

Poor Prognosis ◽

Inferior Vena ◽

Transfusion Requirement ◽

Vena Cava ◽

Acute Care Surgery ◽

Care Surgery

Flat inferior vena cava (IVC) on ultrasound examination has been shown to correlate with hypovolemic status. We hypothesize that a flat IVC on limited echocardiogram (LTTE) performed in the emergency room (ER) correlates with poor prognosis in acutely ill surgical patients. We conducted a retrospective review of all patients undergoing LTTE in the ER from September 2010 until June 2011. IVC diameter was estimated by subxiphoid window. Flat IVC was defined as diameter less than 2 cm. Fat IVC was defined as diameter greater than 2 cm. Need for intensive care unit admission, blood transfusion requirement, mortality, and need for emergent operation between patients with flat versus Fat IVC were compared. One hundred one hypotensive patients had LTTE performed in the ER. Average age was 38 years. Admission diagnosis was blunt trauma (n = 80), penetrating trauma (n = 13), acute care surgery pathology (n = 7), and burn (n = 1). Seventy-four patients had flat IVC on initial LTTE. Compared with those with fat IVC, flat patients were found have higher rates of intensive care unit admission (51.3 vs 14.8%; P = 0.001), blood transfusion requirement (12.2 vs 3.7%), and mortality (13.5 vs 3.7%). This population also underwent emergent surgery on hospital Day 1 more often (16.2 vs 0%; P = 0.033). Initial flat IVC on LTTE is an indicator of hypovolemia and a predictor of poor outcome.

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