scholarly journals Lung ultrasound for volume status assessment in chronic hemodialysis patients

2020 ◽  
Vol 77 (9) ◽  
pp. 943-949
Author(s):  
Igor Ivanov ◽  
Vladimir Veselinov ◽  
Dejan Celic ◽  
Jadranka Dejanovic ◽  
Dusanka Obradovic ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Lung Ultrasound ◽  
Vena Cava ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Chronic Hemodialysis ◽  
Volume Status ◽  
Before And After ◽  
Status Assessment

Backoground/Aim. Assessing volume status in chronic hemodialysis (HD) patients is difficult despite several techniques have been developed. The aim of this study was to demonstrate the adequacy and efficacy of lung ultrasound (LUS) and B line score (BLS) in the assessment of volume status in patients on HD in comparison to other techniques: ultrasonographic determination of inferior vena cava diameter (IVCD), echocardiography (ECHO) and B-type natriuretic peptide (BNP) determination. Methods. LUS, ECHO, ultrasonography of inferior vena cava in inspiration (IVCDi) and expiration (IVCDe), and BNP sampling were performed before and after HD in 83 patients. Results. A significant reduction of BLS, IVCDi, IVCDe, BNP and several ECHO parameters such as left atrium diameter (LA), left ventricular internal dimension in diastole and systole (LVIDd and LVIDs, respectively), and left atrial volume in systole (LAVs), was registered (p < 0.001). There was a significant correlation between BLS and BNP before (p = 0.01) and after HD (p = 0.05), and a weaker but significant correlation between BLS and IVCDi and IVCDe before HD (p = 0.05). Conclusion. All techniques assessed hypervolemia before and after HD successfully. BNP correlated with LUS before and after HD, and IVCDi and IVCDe correlated with LUS only before HD. LUS is cheap and simple to perform, can be performed bedside and can be reliably used for assessing volume status in HD patients.

scholarly journals Measurement of Inferior Ven Cava Collapsibility Index and Its Correlation to Central Venous Pressure in Adult Critically Ill Patients a Prospective Observational Study

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Inferior Vena Cava ◽  
Central Venous Pressure ◽  
Inferior Vena ◽  
Venous Pressure ◽  
Vena Cava ◽  
Volume Status ◽  
P Value ◽  
Central Venous ◽  
Collapsibility Index ◽  
Status Assessment

Fluid therapy is an essential component part management of critically ill patients. Proper estimation of the amount of needed fluids is of great importance due to the well-established adverse effects of marked negative and positive fluids balance. Central venous pressure has been widely used by ICU physicians for volume status assessment. Several methods have been postulated for volume status assessment, among which is the inferior vena cava collapsibility index. As the inferior vena cava is a thin-walled capacitance vessel that adjusts to the body’s volume status by changing its diameter depending on the total body fluid volume. Giving the fact that bed-side ultrasonographic measurement of inferior vena cava diameters is an available, non-invasive, reproducible and quiet easy-to-learn technique, it can provide a safe and quiet reliable replacement of central venous pressure measurement for assessment of volume status assessment. The aim of this study was to find statistical correlation between central venous pressure and caval index, as a step towards validating the above mentioned replacement. 86 critically ill patients from ICU population were enrolled. Simultaneous measurements of central venous pressure and inferior vena cava collapsibility index were observed and recorded on four sessions. Patients were also grouped based on their mode of ventilation and central venous pressure values in order to compare the strength of correlation between various populations. The results showed that Inferior vena cava collapsibility index has significant inverse correlation with CVP value (r= -85, p value ˂0.001 at 95% CI) and it better correlated with mean arterial blood pressure and lactate clearance as compared to central venous pressure. However it correlated better with CVP in spontaneously breathing patients (r= -0.86, p value ˂0.001) than in mechanically ventilated patients (r= -0.84, p value ˂0.001). Inferior vena cava collapsibility index has shown to correlate better with CVP value in lower values (˂ 10 cmH2O) (r= -0.8, p value ˂0.001) than in higher values (≥ 10 cmH2O) (r= -0.6, p value ˂0.001). In addition, an inferior vena caval collapsibility index cut-off value of 29% was shown to discriminate between CVP values ˂10 cmH2O and values ≥10 cmH2O with high Sensitivity (88.6%) and specificity (80.4%). In conclusion, inferior vena cava collapsibility index has a strong inverse relationship with central venous pressure which is more pronounced at low central venous pressure values. Point-of-care ultrasonographically-measured inferior vena cava collapsibility index is very likely to be a good alternative to central venous pressure measurement with a high degree of precision and reproducibility. However, Wide scale studies are needed to validate its use in different patient populations.

scholarly journals Inferior Vena Cava Collapsibility Index: A Precise Non-invasive Tool for Evaluation of Edema in Children with Nephrotic Syndrome.

2021 ◽  
Author(s):  
Hanan El-Halaby ◽  
Ashraf Bakr ◽  
Mohamed El-Assmy ◽  
Hussein Abdelaziz Abdalla ◽  
Marwa Salem ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Fractional Excretion ◽  
Volume Status ◽  
Non Invasive ◽  
Collapsibility Index ◽  
Fractional Excretion Of Sodium ◽  
Status Assessment

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.

scholarly journals Automated Volume Status Assessment Using Inferior Vena Cava Pulsatility

Electronics ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 1671
Author(s):  
Luca Mesin ◽  
Silvestro Roatta ◽  
Paolo Pasquero ◽  
Massimo Porta
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Volume Status ◽  
Current Standard ◽  
Clinical Method ◽  
Non Invasive ◽  
Video Clips ◽  
Status Assessment ◽  
Leave One Out

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.

scholarly journals Role of Lung Ultrasound and Inferior Vena Cava Diameter in Assessment of Patients with Heart Failure

2021 ◽  
Vol 85 (2) ◽  
pp. 4102-4107
Author(s):  
Hussein Abd El-Fattah Mohammed ◽  
Mohamed Salah El-Feshawy ◽  
Fareed Shawky Basiony ◽  
Mustafa Abu shady
Keyword(s):  
Heart Failure ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Lung Ultrasound ◽  
Vena Cava ◽  
Patients With Heart Failure ◽  
Inferior Vena Cava Diameter

Ultrasound of the Inferior Vena Cava Can Assess Volume Status in Pediatric Patients

2009 ◽  
Vol 37 (2) ◽  
pp. 219 ◽  
Author(s):  
S. Ayvazyan ◽  
E. Dickman ◽  
A. Likourezos ◽  
S. Wu ◽  
H. Hannan ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Pediatric Patients ◽  
Inferior Vena ◽  
Vena Cava ◽  
Volume Status

A Novel Parameter Derived From Photoplethysmographic Pulse Wave to Predict Risk of Postreperfusion Syndrome

2020 ◽  
Author(s):  
Hai-ying Kong ◽  
Xian Zhao ◽  
Su-Qin Huang
Keyword(s):  
Liver Transplantation ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Pulse Wave ◽  
Surgical Stress ◽  
Vena Cava ◽  
Stress Index ◽  
Increased Risk ◽  
Sympathetic Modulation ◽  
Before And After

Abstract BackgroundPostreperfusion syndrome (PRS), observed after reperfusion of the grafted liver, was associated with poor outcome. The end-stage liver disease (ESLD) with autonomic dysfunction in the cardiovascular system has greater risk of developing of PRS, due to the poor ability in sympathetic vasoconstriction. Surgical Stress Index (SSI) is a novel parameter derived from photoplethysmographic pulse wave to assess central sympathetic modulation in awake volunteers. In this study, we determined the relationship between SSI values and the risk of developing of PRS during orthotopic liver transplantation.MethodsWe retrospectively studied 163 patients who had undergone OLT, and divided the patients into PRS group and non-PRS group. SSI and related parameters were determined 5min before and after clamping of the inferior vena cava, the occurrence of PRS were recorded during reperfusion.ResultsThe clamping of the inferior vena cava modified the SSI significantly, accompanied with significant hemodynamic response. The SSI increased significantly after clamping (47.0 (43.0-49.0 ) vs.81.0(69.5-89.0), p<0.001). The SSI increased by 45.3% at 5min after clamping of the inferior vena cava in the PRS group, as opposed to 81.7% in the non-PRS group (P = 0.037). PRS occurred in only 19.4% of patients in whom the SSI increased by more than 50%. Based on a multivariate analysis, percentage of the variation in the SSI was associated with a significant increased risk in developing the PRS (OR 2.49, 95% CI 1.15-5.02; P=0.021).ConclusionsSSI can sensitively indicate the central sympathetic modulation function during liver transplantation procedure. SSI might be a sensitive marker of risk of developing PRS.

Mechanism of hemodynamic responses to occlusion of the descending thoracic aorta

1980 ◽  
Vol 238 (4) ◽  
pp. H423-H429 ◽  
Author(s):  
O. Stokland ◽  
M. M. Miller ◽  
A. Ilebekk ◽  
F. Kiil
Keyword(s):  
Inferior Vena Cava ◽  
Superior Vena Cava ◽  
Inferior Vena ◽  
Superior Vena ◽  
Vena Cava ◽  
Spinal Column ◽  
Left Ventricular Pressure ◽  
Left Ventricular ◽  
Aortic Occlusion ◽  
Systolic Volume

To examine left ventricular responses to aortic occlusion, changes in end-diastolic volume (EDV) and end-systolic volume (ESV) were estimated by ultrasonic recordings of myocardial distances in atropinized open-chest dogs. During aortic occlusion EDV and ESV increased equally, systolic left ventricular pressure (LVP) rose by 86 +/- 8 mmHg, and blood flow more than doubled in the superior vena cava and fell by 90% in the inferior vena cava. During combined occlusion of aorta and inferior vena cava, systolic LVP and superior vena cava flow did not rise above control and EDV declined. By infusing 25 +/- 2 ml/kg body wt of blood during combined occlusion, the effects of aortic occlusion could be reproduced; control values before blood infusion were reestablished by withdrawal of only one-third of the infused volume, indicating a shunt line along the spinal column. Thus during aortic occlusion, transfer of blood accounts for the rise in EDV and increased activation of the Frank-Starling mechanism; increased afterload raises ESV as much as EDV in anesthetized dogs not subjected to sympathetic stimulation. Consequently, stroke volume is maintained and systolic LVP increased.

P1807COMPARISON BETWEEN INFERIOR VENA CAVA DIAMETER, BIOIMPEDANCE SPECTROSCOPY AND CLINICAL CRITERION FOR DRY WEIGHT ESTIMATION IN HEMODIALYZED CHILDREN

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Varvara Askiti ◽  
Georgia Malakasioti ◽  
George Servos ◽  
Georgia Grigoriadou ◽  
Andromachi Mitsioni
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
New Technologies ◽  
Fluid Overload ◽  
Vena Cava ◽  
Dry Weight ◽  
Chronic Hemodialysis ◽  
Hydration Status ◽  
Clinical Criteria

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&lt;0,05) and to IVCDi (r=0,4, r=0,5, p&lt;0,05) and IVCDe (r=0,4, r=0,6, p&lt;0,05). A negative association between IVCCI and relOH-BIS was observed (r= -0,4, p&lt;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 &lt;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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