Ultrasound reference values for inferior vena cava diameter and collapsibility index among adult Nigerians

2019 ◽  
Vol 26 (1) ◽  
pp. 25
Author(s):  
AdemolaA Adeyekun ◽  
OguguaAnnie Ifijeh ◽  
AdenikeO Akhigbe ◽  
MohammedMunir Abubakar
2017 ◽  
Vol 3 (2) ◽  
pp. 88
Author(s):  
Muhammad Artisto Adi Yussac ◽  
Dharmeizar Dharmeizar ◽  
Murdani Abdullah ◽  
Dono Antono ◽  
Muhadi Muhadi

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.


2000 ◽  
Vol 14 (10-11) ◽  
pp. 903-907 ◽  
Author(s):  
Tobias Dietel ◽  
Guido Filler ◽  
Ryszard Grenda ◽  
Norman Wolfish

2004 ◽  
Vol 30 (9) ◽  
Author(s):  
Marc Feissel ◽  
Fr�d�ric Michard ◽  
Jean-Pierre Faller ◽  
Jean-Louis Teboul

2020 ◽  
Vol 5 (1) ◽  

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.


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