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Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
Published on: January 13, 2023
The Correlation Between Inferior Vena Cava Diameter Measured by Ultrasonography and Central Venous Pressure
Hans Vaish1, Virendra Kumar2, Rama Anand2
1Department of Pediatric Intensive Care Unit, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, Cannaught Place, New Delhi, 110001, India. drhansvaish@gmail.com.
Insights
This study found that fluid resuscitation in pediatric shock improves inferior vena cava (IVC) diameter and decreases IVC compressibility index (CI). IVC diameter correlates positively with central venous pressure (CVP), while CI correlates negatively.
Area of Science:
- Pediatric Intensive Care
- Critical Care Medicine
- Cardiovascular Physiology
Background:
- Assessing fluid responsiveness in pediatric shock is critical.
- Central venous pressure (CVP) is an invasive measure of fluid status.
- Non-invasive ultrasound markers like IVC diameter and CI are potential alternatives.
Purpose of the Study:
- To investigate the correlation between inferior vena cava (IVC) diameters, IVC compressibility index (CI), and central venous pressure (CVP) in pediatric shock.
- To evaluate the effectiveness of fluid resuscitation on these parameters.
Main Methods:
- Prospective observational study in a pediatric intensive care unit.
- Enrolled 50 children (5-18 years) with shock.
- Measured IVC diameters, CI, and CVP serially after admission and treatment.
Main Results:
- Septic shock was the predominant diagnosis (>80%).
- Initial CVP showed a positive correlation with IVC diameter (r=+0.312) and a negative correlation with CI (r=-0.343).
- Fluid resuscitation led to improved IVC diameters, decreased CI, and improved hemodynamic parameters (HR, SBP).
Conclusions:
- Inferior vena cava diameter and compressibility index are valuable non-invasive indicators of fluid status in pediatric shock.
- Effective fluid resuscitation improves IVC diameter and decreases CI, reflecting improved CVP.
- These ultrasound parameters can guide fluid management in critically ill children.
Objective:
To find a correlation between inferior vena cava (IVC) diameters, IVC compressibility index (CI) and central venous pressure (CVP).
Methods:
Prospective observational study was done at pediatric intensive care unit (PICU) of Kalawati Saran Children's Hospital (KSCH). Fifty children aged 5-18 y, presenting with shock were enrolled for the study. IVC diameters, CI and relevant clinical data were noted at enrollment, 30 min, 1 h, 6 h, and 12 h. Central line was placed at the time of admission.
Results:
Of 50 children enrolled, 28 were boys, with a mean age of 11 y. More than 80% of cases were diagnosed as septic shock. Mean maximum and minimum IVC diameter of 8.3 ± 2 mm and 3.7 ± 1.7 mm, respectively CI 58.2 ± 7% and CVP of 5.4 ± 1.5 cm of H2O was observed at admission. CVP and IVC diameters showed a serial improvement with treatment; CI showed a serial decrease with treatment. Heart rate (HR) and systolic blood pressure (SBP) also showed a serial improvement at 12 h (p < 0.05). CVP showed a positive correlation with IVC diameter (r +0.312; p < 0.05), and a negative correlation with CI (r -0.343; p < 0.05).
Conclusions:
Effective fluid resuscitation improves IVC diameters with a decrease in CI. IVC diameter has a positive correlation to CVP and CI has a negative correlation to CVP.
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