Agreement Between Inferior Vena Cava Diameter Measurements by Subxiphoid Versus Transhepatic Views

Overview

Journal Indian J Crit Care Med

Specialty Critical Care

Date 2016 Jan 28

PMID 26816446

Citations 8

Authors

Atul Prabhakar Kulkarni

S Janarthanan

M M Harish

Siddique Suhail

Harish Chaudhari

Vandana Agarwal

Vijaya P Patil

Jigeeshu V Divatia

Affiliations

Soon will be listed here.

Abstract

Context: Correcting hypovolemia is extremely important. Central venous pressure measurement is often done to assess volume status. Measurement of inferior vena cava (IVC) is conventionally done in the subcostal view using ultrasonography. It may not be possible to obtain this view in all patients.

Aims: We therefore evaluated the limits of agreement between the IVC diameter measurement and variation in subcostal and that by the lateral transhepatic view.

Settings And Design: Prospective study in a tertiary care referral hospital intensive care unit.

Subjects And Methods: After Institutional Ethics Committee approval and informed consent, we obtained 175 paired measurements of the IVC diameter and variation in both the views in adult mechanically ventilated patients. The measurements were carried out by experienced researchers. We then obtained the limits of agreement for minimum, maximum diameter, percentage variation of IVC in relation to respiration.

Statistical Analysis Used: Bland-Altman's limits of agreement to get precision and bias.

Results: The limits of agreement were wide for minimum and maximum IVC diameter with variation of as much as 4 mm in both directions. However, the limits of agreement were much narrower when the percentage variation in relation to respiration was plotted on the Bland-Altman plot.

Conclusions: We conclude that when it is not possible to obtain the subcostal view, it is possible to use the lateral transhepatic view. However, using the percentage variation in IVC size is likely to be more reliable than the absolute diameter alone. It is possible to use both views interchangeably.

Citing Articles

Inferior vena cava distensibility during pressure support ventilation: a prospective study evaluating interchangeability of subcostal and trans‑hepatic views, with both M‑mode and automatic border tracing.

Zawadka M, Santonocito C, Dezio V, Amelio P, Messina S, Cardia L J Clin Monit Comput. 2024; 38(5):981-990.

PMID: 38819726 PMC: 11427491. DOI: 10.1007/s10877-024-01177-8.

Point-of-Care Echocardiography in the Difficult-to-Image Patient in the ICU: A Narrative Review.

Grotberg J, McDonald R, Co I Crit Care Explor. 2024; 6(1):e1035.

PMID: 38222871 PMC: 10786596. DOI: 10.1097/CCE.0000000000001035.

Subcostal versus right lateral ultrasound measurements of inferior vena cava: Measurements obtained from these two views are not equivalent in non-ICU patients.

Haroun F, Robinson M, Shayman C, Cotton J Ultrasound. 2023; 31(3):196-203.

PMID: 37538967 PMC: 10395380. DOI: 10.1177/1742271X221124901.

Inferior vena cava distensibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on mechanically ventilated patients.

Sanfilippo F, La Via L, Dezio V, Amelio P, Genoese G, Franchi F Intensive Care Med Exp. 2023; 11(1):40.

PMID: 37423948 PMC: 10329966. DOI: 10.1186/s40635-023-00529-z.

Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteers.

Sanfilippo F, La Via L, Dezio V, Santonocito C, Amelio P, Genoese G Intensive Care Med Exp. 2023; 11(1):15.

PMID: 37009935 PMC: 10068684. DOI: 10.1186/s40635-023-00505-7.

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