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Indian Journal of Clinical Anaesthesia


Correlation of ultrasound guided measurement of inferior vena cava diameter to central venous pressure to assess the volume status of intensive care unit patients


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Author Details: Placid Siroraj, Sunder Panneerselvam, CR Saravannan

Volume : 4

Issue : 1

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 112

Article End Page : 117


Abstract

Background: Assessment of intravascular volume status is an essential parameter for the diagnosis and management of critically-ill patients. In order to assess the intravascular volume status noninvasively, we conducted a study to to find the correlation, if any, between sonographic IVC collapsibility index and Central Venous Pressure to assess the volume status in ICU patients.
Methods: The Institutional Ethics Committee approval was obtained. 60 spontaneously breathing post-operative patients with a functioning central venous catheter were recruited for this study. The distal port of the catheter was connected to a pressure transducer and the pressure displayed on the monitor in mmHg was noted. Simultaneously the IVC diameters during end inspiration and end expiration were measured in the longitudinal and transverse orientations using the M-mode of the ultrasound machine. The Collapsibility Index was calculated from the IVC diameters. Collapsibility Index? 50% suggested hypovolemia and Collapsibility Index <50% suggested euvolemia or hypervolemia. This was compared with the measured Central Venous Pressure to find the correlation between the two. Additionally the change in IVC diameter with Central Venous Pressure was observed. The IVC Collapsibility Index for longitudinal and transverse orientations were calculated separately and they were compared with each other to find which among them correlated the best with the Central Venous Pressure.
Results: In our study the IVC Collapsibility Index correlated well with the Central Venous Pressure. The sensitivity and specificity of IVC Collapsibility to Central Venous Pressure were also found to be statistically significant. The change in IVC diameters were also found to be statistically significant when compared to Central Venous Pressure. The sensitivity of the IVC Collapsibility Index in the longitudinal orientation was much better than that of the transverse orientation to detect low CVP.
Conclusion: IVC Collapsibility Index can be used as an alternative to CVP measurement to guide us in the fluid management of patients in the ICU.

Keywords:
Ultrasound, IVC diameter, IVC collapsibility index, CVP