IVC ultrasound - Revision history

Rossdonaldson1: /* Video */

2024-04-17T20:13:05Z

Video

← Older revision		Revision as of 20:13, 17 April 2024
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	File:Plethoric IVC 2.gif		File:Plethoric IVC 2.gif
	</gallery>		</gallery>

	~~==Video==~~
	~~{{#widget:YouTube\|id= ci9W4MvyMHI}}~~

	==External Links==		==External Links==

Naiemf: /* Flat IVC */

2020-08-30T02:30:25Z

Flat IVC

← Older revision		Revision as of 02:30, 30 August 2020
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	File:Flat IVC 2.gif		File:Flat IVC 2.gif
	</gallery>		</gallery>

	===Plethoric IVC===		===Plethoric IVC===
	<gallery>		<gallery>

SLuckettG: /* Pearls and Pitfalls */

2019-03-23T00:45:09Z

Pearls and Pitfalls

← Older revision		Revision as of 00:45, 23 March 2019
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	==Pearls and Pitfalls==		==Pearls and Pitfalls==
	*Aorta can be confused for IVC, ensure ~~your~~ visualize the vessel entering the atrium		*Aorta can be confused for IVC, ensure you visualize the vessel entering the atrium
	*Ensure the vessel is viewed in full longitudinal axis as being off center will give falsely narrow measurements		*Ensure the vessel is viewed in full longitudinal axis as being off-center will give falsely narrow measurements

	==Documentation==		==Documentation==

SLuckettG: /* Indications */

2019-03-23T00:44:13Z

Indications

← Older revision		Revision as of 00:44, 23 March 2019
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	*Differentiate causes of shock		*Differentiate causes of shock
	*Differentiate causes of shortness of breath		*Differentiate causes of shortness of breath
			*Establish likelihood of fluid responsiveness
			*Assess response to interventions

	==Technique==		==Technique==

SLuckettG: /* Background */

2019-03-23T00:43:40Z

Background

← Older revision		Revision as of 00:43, 23 March 2019
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	*Though controversial, IVC measurement by ultrasound can estimate volume status, fluid responsiveness, and fluid tolerance		*Though controversial, IVC measurement by ultrasound can estimate volume status, fluid responsiveness, and fluid tolerance
	**There is evidence to support that IVC diameter is consistently low in hypovolemia versus euvolemia<ref>Dipti A, et al. Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. AJEM. 2012; 30:1414-1419.</ref>		**There is evidence to support that IVC diameter is consistently low in hypovolemia versus euvolemia<ref>Dipti A, et al. Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. AJEM. 2012; 30:1414-1419.</ref>
	**IVC change can estimate fluid responsiveness with ~~a Sn~~ 0.78 and Sp 0.86<ref>Zhang Z, et al. Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound Med Biol. 2014. May; 40(5):845-53.</ref>		**IVC change can estimate fluid responsiveness with sensitivity of 0.78 and specificity of 0.86<ref>Zhang Z, et al. Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound Med Biol. 2014. May; 40(5):845-53.</ref>
	*Can use as a dynamic assessment after intervention such as giving fluids or passive leg raise		*Can use as a dynamic assessment after intervention such as giving fluids or passive leg raise
	*Dynamic changes is probably best measured in intubated patients		*Dynamic changes is probably best measured in intubated patients

	==Indications==		==Indications==
	*Differentiate causes of shock		*Differentiate causes of shock

TJYE: /* Normal Exam */

2017-04-08T03:32:01Z

Normal Exam

← Older revision		Revision as of 03:32, 8 April 2017
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	==Documentation==		==Documentation==
	===Normal Exam===		===Normal Exam===
	A bedside IVC ultrasound was performed to assess volume status in setting of dehydration. The IVC was identified in longitudinal access. The IVC was neither flat nor plethoric. There was less than 50% collapse with respirophasic measurements. ~~There was no evidence of~~ volume ~~depletion~~.		A bedside IVC ultrasound was performed to assess volume status in setting of dehydration. The IVC was identified in longitudinal access. The IVC was neither flat nor plethoric. There was less than 50% collapse with respirophasic measurements. This does not imply that the patient is not volume responsive but rather further testing is needed.

	===Abnormal Exam===		===Abnormal Exam===
	A bedside IVC ultrasound was performed to assess volume status in setting of dehydration. The IVC was identified in longitudinal access. The IVC was flat with over 50% collapse with respirophasic measurements. There was evidence of volume depletion and fluid tolerance.		A bedside IVC ultrasound was performed to assess volume status in setting of dehydration. The IVC was identified in longitudinal access. The IVC was flat with over 50% collapse with respirophasic measurements. There was evidence of volume depletion and fluid tolerance.

Neil.m.young: Text replacement - "* " to "*"

2016-08-03T15:17:25Z

Text replacement - "* " to "*"

← Older revision		Revision as of 15:17, 3 August 2016
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	#*May start with subxyphoid view, place right atrium in center of screen and rotate probe 90 degrees clockwise to find IVC		#*May start with subxyphoid view, place right atrium in center of screen and rotate probe 90 degrees clockwise to find IVC
	#Longitudinal view		#Longitudinal view
	#* M-mode to measure IVC collapse during inspiration or estimation can be made in 2D with IVC in longitudinal axis		#*M-mode to measure IVC collapse during inspiration or estimation can be made in 2D with IVC in longitudinal axis
	#*Measure both absolute diameter of IVC and percent collapse during inspiration of spontaneously breathing patients		#*Measure both absolute diameter of IVC and percent collapse during inspiration of spontaneously breathing patients
	#Dynamic measurements		#Dynamic measurements

Neil.m.young: Neil.m.young moved page Ultrasound: IVC to IVC ultrasound

2016-07-25T11:33:53Z

Neil.m.young moved page Ultrasound: IVC to IVC ultrasound

← Older revision	Revision as of 11:33, 25 July 2016
(No difference)

Neil.m.young at 11:33, 25 July 2016

2016-07-25T11:33:09Z

← Older revision		Revision as of 11:33, 25 July 2016
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	#Location		#Location
	#*In subxyphoid cardiac view (epigastric), fan probe laterally to view the IVC draining and identify it draining into the right atrium		#*In subxyphoid cardiac view (epigastric), fan probe laterally to view the IVC draining and identify it draining into the right atrium
	**may start with subxyphoid view, place right atrium in center of screen and rotate probe 90 degrees clockwise to find IVC		#*May start with subxyphoid view, place right atrium in center of screen and rotate probe 90 degrees clockwise to find IVC
	#Longitudinal view		#Longitudinal view
	#* M-mode to measure IVC collapse during inspiration or estimation can be made in 2D with IVC in longitudinal axis		#* M-mode to measure IVC collapse during inspiration or estimation can be made in 2D with IVC in longitudinal axis

Neil.m.young at 11:32, 25 July 2016

2016-07-25T11:32:44Z

← Older revision		Revision as of 11:32, 25 July 2016
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	==Background==		==Background==
	*Though ~~contriversal~~, IVC measurement by ultrasound can estimate volume status and fluid ~~responsiveness~~		*Though controversial, IVC measurement by ultrasound can estimate volume status, fluid responsiveness, and fluid tolerance
	**There is ~~moderate~~ evidence to support that IVC diameter is consistently low in hypovolemia vs euvolemia<ref>Dipti A, et al. Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. AJEM. 2012; 30:1414-1419.</ref>		**There is evidence to support that IVC diameter is consistently low in hypovolemia versus euvolemia<ref>Dipti A, et al. Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. AJEM. 2012; 30:1414-1419.</ref>
	**~~It is suggested that~~ IVC change can estimate fluid responsiveness with a Sn 0.78 and Sp 0.86<ref>Zhang Z, et al. Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound Med Biol. 2014. May; 40(5):845-53.</ref>		**IVC change can estimate fluid responsiveness with a Sn 0.78 and Sp 0.86<ref>Zhang Z, et al. Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound Med Biol. 2014. May; 40(5):845-53.</ref>
	*Measure both absolute diameter of IVC and percent collapse during inspiration of spontaneously breathing patients		*Can use as a dynamic assessment after intervention such as giving fluids or passive leg raise
	*Can use as a dynamic assessment after intervention (giving fluids)		*Dynamic changes is probably best measured in intubated patients
	*~~Unclear if applicable to~~ intubated patients
			==Indications==
			*Differentiate causes of shock
			*Differentiate causes of shortness of breath

	==Technique==		==Technique==
	*~~Use curvilinear (abdominal) probe~~ or phased array ~~(cardiac)~~ probe		#Select probe
	*In subxyphoid cardiac view (epigastric), fan probe laterally to view the IVC draining into the right atrium		#*Curvilinear or phased array probe
			#Location
			#*In subxyphoid cardiac view (epigastric), fan probe laterally to view the IVC draining and identify it draining into the right atrium
	**may start with subxyphoid view, place right atrium in center of screen and rotate probe 90 degrees clockwise to find IVC		**may start with subxyphoid view, place right atrium in center of screen and rotate probe 90 degrees clockwise to find IVC
	**Use M-mode to measure IVC collapse during inspiration or estimation can be made in 2D with IVC in longitudinal axis		#Longitudinal view
			#* M-mode to measure IVC collapse during inspiration or estimation can be made in 2D with IVC in longitudinal axis
			#*Measure both absolute diameter of IVC and percent collapse during inspiration of spontaneously breathing patients
			#Dynamic measurements
			#*Repeat measurements can be made after passive leg raise or IVF bolus

	~~[[File:IVC.png\|300px]]~~		==Findings==
			{{Ultrasound findings for critically ill patients table}}
	==~~Measurements~~==
	===Correlations Between IVC Size and CVP<ref>Goldflam K, et al. Focus on: Inferior vena cava ultrasound. ACEP News. June 2011.</ref>===		===Correlations Between IVC Size and CVP<ref>Goldflam K, et al. Focus on: Inferior vena cava ultrasound. ACEP News. June 2011.</ref>===
	{\| class="wikitable"		{\| class="wikitable"
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	''Measure 2cm from IVC/RA junction or 1cm from IVC/hepatic vein junction''		''Measure 2cm from IVC/RA junction or 1cm from IVC/hepatic vein junction''

	~~{{Ultrasound findings~~ for ~~critically ill patients table}}~~		==Images==
			[[File:IVC.png\|300px]]

			==Pearls and Pitfalls==
			*Aorta can be confused for IVC, ensure your visualize the vessel entering the atrium
			*Ensure the vessel is viewed in full longitudinal axis as being off center will give falsely narrow measurements

			==Documentation==
			===Normal Exam===
			A bedside IVC ultrasound was performed to assess volume status in setting of dehydration. The IVC was identified in longitudinal access. The IVC was neither flat nor plethoric. There was less than 50% collapse with respirophasic measurements. There was no evidence of volume depletion.
			===Abnormal Exam===
			A bedside IVC ultrasound was performed to assess volume status in setting of dehydration. The IVC was identified in longitudinal access. The IVC was flat with over 50% collapse with respirophasic measurements. There was evidence of volume depletion and fluid tolerance.

			A bedside IVC ultrasound was performed to assess volume status in setting of fluid overload. The IVC was identified in longitudinal access. The IVC was plethoric with less than 50% collapse with respirophasic measurements. There was evidence of volume overload.

			==Clips==
			===Normal IVC===
			<gallery>
			File:Normal IVC.gif
			File:Normal IVC 2.gif
			</gallery>
			===Flat IVC===
			<gallery>
			File:Flat IVC.gif
			File:Flat IVC 2.gif
			</gallery>
			===Plethoric IVC===
			<gallery>
			File:Plethoric IVC.gif
			File:Plethoric IVC 2.gif
			</gallery>

	==Video==		==Video==
	{{#widget:YouTube\|id= ci9W4MvyMHI}}		{{#widget:YouTube\|id= ci9W4MvyMHI}}

			==External Links==
			*[http://lifeinthefastlane.com/smacc-the-dark-art-of-ivc-ultrasound/ Life in the Fastlane - SMACC: The Dark Art of IVC Ultrasound]
			*[https://www.acep.org/content.aspx?id=80791 ACEP Focus On: Inferior Vena Cava Ultrasound]

	==See Also==		==See Also==
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	<references/>		<references/>

	~~[[Category:Cardiology]] [[Category:Radiology]]~~
	[[Category:Ultrasound]]		[[Category:Ultrasound]]
			[[Category:Radiology]]
			[[Category:Cardiology]]