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Updated: Feb 10, 2026

Author Spotlight: Exploring Venous Waveforms in Porcine Models to Tackle Volume Overload in Medicine
Published on: January 12, 2024
Peripheral Intravenous Volume Analysis (PIVA) for Quantitating Volume Overload in Patients Hospitalized With Acute
Merrick Miles1, Bret D Alvis1, Kyle Hocking2
1Vanderbilt University Medical Center, Department of Anesthesiology, Division of Critical Care, Nashville, Tennessee.
Background:
To determine the feasibility of peripheral intravenous volume analysis (PIVA) of venous waveforms for assessing volume overload in patients admitted to the hospital with acute decompensated heart failure (ADHF).
Methods:
Venous waveforms were captured from a peripheral intravenous catheter in subjects admitted for ADHF and healthy age-matched controls. Admission PIVA signal, brain natriuretic peptide, and chest radiographic measurements were related to the net volume removed during diuresis.
Results:
ADHF patients had a significantly greater PIVA signal on admission compared with the control group (P = .0013, n = 18). At discharge, ADHF patients had a PIVA signal similar to the control group. PIVA signal, not brain natriuretic peptide or chest radiographic measures, accurately predicted the amount of volume removed during diuresis (R2 = 0.781, n = 14). PIVA signal at time of discharge greater than 0.20, demonstrated 83.3% 120-day readmission rate.
Conclusions:
This study demonstrates the feasibility of PIVA for assessment of volume overload in patients admitted to the hospital with ADHF.
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