Dataset Information

Is there an association between central venous pressure measurement and ultrasound assessment of the inferior vena cava?

ABSTRACT:

Introduction

Early assessment of volume status is paramount in critically ill patients. Central venous pressure (CVP) measurement and ultrasound assessment of the inferior vena cava (IVC) are both used for volume assessment in the emergency centre. Recent data is conflicting over whether there is a correlation between CVP and ultrasound assessment of the IVC.

Methods

This was a retrospective review of an audit previously performed in the Emergency Unit of Ngwelezane Hospital in Kwazulu-Natal. The audit involved measuring inferior vena cava collapsibility index (IVC-CI) within 5?min of CVP measurement. In this retrospective study, audit data were analysed to determine if an association exists.

Results

Twenty-four patients were included. The median age of participants was 36 (IQR 42) years (95% CI 33-56). The median time to ultrasound was 18.6 (52.5)?h (95% CI 7.5-36.2). The mean CVP was 13.7?±?7.7?cm H₂O and mean IVC-CI was 39.4?±?17.8%. Based on a Pearson correlation test, there was a weak negative correlation between CVP and IVC-CI, which was not statistically significant (r?=?-0.05, n?=?24, p?=?0.81, 95% CI -0.5 to 0.4) for all participants. However, among females there was a moderate negative correlation between CVP and IVC-CI, which was not statistically significant (r?=?-0.43, n?=?7, p?=?0.34, 95% CI -0.9 to 0.5), while among males there was a weak positive correlation, which was not statistically significant (r?=?0.16, n?=?17, p?=?0.53, 95% CI -0.3 to 0.6).

Discussion

There is no significant correlation between CVP and IVC-CI. Further validation research is required to support our preliminary findings of no significant correlation between CVP measurement and ultrasound assessment of the IVC. CVP and IVC ultrasound should be used as clinical adjuncts, and not as stand-alone measures of volume assessment.

SUBMITTER: Govender J

PROVIDER: S-EPMC6223593 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

Is there an association between central venous pressure measurement and ultrasound assessment of the inferior vena cava?

Govender J J Postma I I Wood D D Sibanda W W

African journal of emergency medicine : Revue africaine de la medecine d'urgence 20180727 3

<h4>Introduction</h4>Early assessment of volume status is paramount in critically ill patients. Central venous pressure (CVP) measurement and ultrasound assessment of the inferior vena cava (IVC) are both used for volume assessment in the emergency centre. Recent data is conflicting over whether there is a correlation between CVP and ultrasound assessment of the IVC.<h4>Methods</h4>This was a retrospective review of an audit previously performed in the Emergency Unit of Ngwelezane Hospital in Kw ...[more]

PMID: 30456158

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Project description:ImportanceManeuvers assessing fluid responsiveness before an intravascular volume expansion may limit useless fluid administration, which in turn may improve outcomes.ObjectiveTo describe maneuvers for assessing fluid responsiveness in mechanically ventilated patients.RegistrationThe protocol was registered at PROSPERO: CRD42019146781.Information sources and searchPubMed, EMBASE, CINAHL, SCOPUS, and Web of Science were search from inception to 08/08/2023.Study selection and data collectionProspective and intervention studies were selected.Statistical analysisData for each maneuver were reported individually and data from the five most employed maneuvers were aggregated. A traditional and a Bayesian meta-analysis approach were performed.ResultsA total of 69 studies, encompassing 3185 fluid challenges and 2711 patients were analyzed. The prevalence of fluid responsiveness was 49.9%. Pulse pressure variation (PPV) was studied in 40 studies, mean threshold with 95% confidence intervals (95% CI) = 11.5 (10.5-12.4)%, and area under the receiver operating characteristics curve (AUC) with 95% CI was 0.87 (0.84-0.90). Stroke volume variation (SVV) was studied in 24 studies, mean threshold with 95% CI = 12.1 (10.9-13.3)%, and AUC with 95% CI was 0.87 (0.84-0.91). The plethysmographic variability index (PVI) was studied in 17 studies, mean threshold = 13.8 (12.3-15.3)%, and AUC was 0.88 (0.82-0.94). Central venous pressure (CVP) was studied in 12 studies, mean threshold with 95% CI = 9.0 (7.7-10.1) mmHg, and AUC with 95% CI was 0.77 (0.69-0.87). Inferior vena cava variation (∆IVC) was studied in 8 studies, mean threshold = 15.4 (13.3-17.6)%, and AUC with 95% CI was 0.83 (0.78-0.89).ConclusionsFluid responsiveness can be reliably assessed in adult patients under mechanical ventilation. Among the five maneuvers compared in predicting fluid responsiveness, PPV, SVV, and PVI were superior to CVP and ∆IVC. However, there is no data supporting any of the above mentioned as being the best maneuver. Additionally, other well-established tests, such as the passive leg raising test, end-expiratory occlusion test, and tidal volume challenge, are also reliable.

Dataset Information

Is there an association between central venous pressure measurement and ultrasound assessment of the inferior vena cava?

Introduction

Methods

Results

Discussion

Publications

Is there an association between central venous pressure measurement and ultrasound assessment of the inferior vena cava?

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