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Hepatic vein Doppler in critically ill patients: a reflection of central venous pressure or right ventricular

Hongmin Zhang1, Ye Liu2, Qing Zhang3

  • 1Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1# Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China. ozohom@163.com.

BMC Anesthesiology
|October 30, 2022
PubMed

Insights

Hepatic vein systolic filling fraction (SFF) correlates with right ventricular (RV) systolic function in critically ill patients. However, SFF does not show a significant association with central venous pressure (CVP).

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Echocardiography

Background:

  • Assessing right ventricular (RV) systolic function and central venous pressure (CVP) is crucial in critically ill patients.
  • Hepatic vein systolic filling fraction (SFF) is a potential echocardiographic parameter for hemodynamic assessment.

Purpose of the Study:

  • To investigate the association between hepatic vein systolic filling fraction (SFF) and central venous pressure (CVP).
  • To explore the relationship between SFF and right ventricular (RV) systolic function in critically ill patients.

Main Methods:

  • Retrospective enrollment of adult ICU patients undergoing echocardiography.
  • Measurement of hepatic vein systolic velocity (S), diastolic phase velocity (D), and calculation of SFF (S/(S+D)).
  • Definition of RV systolic dysfunction as tricuspid annular plane systolic excursion (TAPSE) < 16 mm.

Main Results:

  • No significant correlation was found between SFF and CVP (r = -0.046, p = 0.500).
  • A significant positive correlation was observed between SFF and TAPSE (r = 0.468, p < 0.001).
  • ROC analysis indicated SFF's AUC for predicting RV systolic dysfunction was 0.759 (p < 0.001), but not for CVP ≥ 10 mmHg (AUC = 0.513, p = 0.775).

Conclusions:

  • Hepatic vein systolic filling fraction (SFF) is significantly associated with right ventricular systolic function in critically ill patients.
  • SFF is not reliably associated with central venous pressure (CVP) in this patient population.
Abstract

Keywords:
Critically illEchocardiographyHepatic veinInferior vena cavaSystolic filling fraction

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