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Published on: January 13, 2023
Femoral Vein Diameter as a Predictor for Intravascular Volume Status.
Kathyayini Revivarman1,2, Nandu M3, Gireesh Kumar2
1Emergency Medicine, Government Medical College, Thiruvananthapuram, Thiruvananthapuram, IND.
Femoral vein diameter (FVD) strongly correlates with central venous pressure (CVP) in hypotensive patients. This study suggests FVD can serve as a reliable surrogate for CVP measurement, aiding in volume status assessment.
Area of Science:
- Emergency Medicine
- Critical Care
- Diagnostic Imaging
Background:
- Central venous pressure (CVP) is crucial for assessing volume status in hypotensive patients.
- Inferior vena cava (IVC) ultrasonography is a common surrogate for CVP, but visualization can be challenging.
- An alternative, easily visualized parameter is needed for CVP estimation.
Purpose of the Study:
- To evaluate the correlation between femoral vein diameter (FVD) and CVP in hypotensive patients.
- To determine if FVD can be used as a reliable non-invasive surrogate marker for CVP.
- To assess the utility of FVD in predicting low and high CVP states.
Main Methods:
- Prospective observational study in an Emergency Department setting.
- Inclusion of hypotensive patients, excluding pregnant women, DVT, acute heart failure, and non-consenting individuals.
- Ultrasound measurement of IVC diameter and FVD, with simultaneous CVP measurement via transducer; Pearson's correlation coefficient calculated.
Main Results:
- A strong positive linear correlation was observed between FVD and CVP (r=0.919, p<0.001).
- The regression equation was CVP = 0.535 + 9.275*FVD.
- FVD <0.8 cm demonstrated 100% specificity for predicting low CVP (<8 mm Hg), while FVD of 1.2 cm showed 90% sensitivity for predicting high CVP (>12 mm Hg).
Conclusions:
- Femoral vein diameter (FVD) is a strong and reliable surrogate marker for central venous pressure (CVP) in hypotensive patients.
- FVD measurement offers a practical alternative to IVC assessment for volume status evaluation.
- Utilizing FVD can help avoid complications associated with unnecessary fluid resuscitation.

