Journal ArticleDOI
Intensivist Use of Hand-Carried Ultrasonography to Measure IVC Collapsibility in Estimating Intravascular Volume Status: Correlations with CVP
S. Peter Stawicki,Benjamin M. Braslow,Nova Panebianco,James N. Kirkpatrick,Vicente H. Gracias,Geoffrey E. Hayden,Anthony J. Dean +6 more
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Measurements of IVC-CI by INBU can provide a useful guide to noninvasive volume status assessment in SICU patients, and appears to correlate best with CVP in the setting of low (<0.20) and high (>0.60) collapsibility ranges.Abstract:
Background Volume status assessment is an important aspect of patient management in the surgical intensive care unit (SICU). Echocardiologist-performed measurement of IVC collapsibility index (IVC-CI) provides useful information about filling pressures, but is limited by its portability, cost, and availability. Intensivist-performed bedside ultrasonography (INBU) examinations have the potential to overcome these impediments. We used INBU to evaluate hemodynamic status of SICU patients, focusing on correlations between IVC-CI and CVP. Study Design Prospective evaluation of hemodynamic status was conducted on a convenience sample of SICU patients with a brief (3 to 10 minutes) INBU examination. INBU examinations were performed by noncardiologists after 3 hours of didactics in interpreting and acquiring two-dimensional and M-mode images, and ≥25 proctored examinations. IVC-CI measurements were compared with invasive CVP values. Results Of 124 enrolled patients, 101 had CVP catheters (55 men, mean age 58.3 years, 44.6% intubated). Of these, 18 patients had uninterpretable INBU examinations, leaving 83 patients with both CVP monitoring devices and INBU IVC evaluations. Patients in three IVC-CI ranges ( 0.60) demonstrated significant decrease in mean CVP as IVC-CI increased (p = 0.023). Although 40% of this group had a CVP >12 mmHg. Conversely, >60% of patients with IVC-CI >0.6 had CVP Conclusions Measurements of IVC-CI by INBU can provide a useful guide to noninvasive volume status assessment in SICU patients. IVC-CI appears to correlate best with CVP in the setting of low ( 0.60) collapsibility ranges. Additional studies are needed to confirm and expand on findings of this study.read more
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Journal ArticleDOI
Focused cardiac ultrasound: recommendations from the American Society of Echocardiography.
Kirk T. Spencer,Bruce J. Kimura,Claudia E. Korcarz,Patricia A. Pellikka,Peter S. Rahko,Robert J. Siegel +5 more
TL;DR: This guideline states that FCU should be used as an Adjunct to Physical Examination when Echocardiography is not Promptly Available and when the patient has no alternative source of care.
Journal ArticleDOI
International Evidence-Based Recommendations for Focused Cardiac Ultrasound
Gabriele Via,Arif Hussain,Mike Wells,Robert F. Reardon,Mahmoud Elbarbary,Vicki E. Noble,James W. Tsung,Aleksandar N. Neskovic,Susanna Price,Achikam Oren-Grinberg,Andrew S. Liteplo,Ricardo Cordioli,Nitha Naqvi,Philippe Rola,Jan Poelaert,Tatjana Golob Guliĉ,Erik Sloth,Arthur J. Labovitz,Bruce J. Kimura,Raoul Breitkreutz,Navroz Masani,Justin Bowra,Daniel Talmor,Fabio Guarracino,Adrian Goudie,Wang Xiaoting,Rajesh Chawla,Maurizio Galderisi,Micheal Blaivas,Tomislav Petrovic,Enrico Storti,Luca Neri,Lawrence Melniker +32 more
TL;DR: For the first time, evidence-based clinical recommendations comprehensively address this branch of point-of-care ultrasound, providing a framework for FoCUS to standardize its application in different clinical settings around the world.
OtherDOI
Dehydration: physiology, assessment, and performance effects.
TL;DR: This article provides a comprehensive review of dehydration assessment and presents a unique evaluation of the dehydration and performance literature, suggesting a ≥ 2% dehydration threshold for impaired endurance exercise performance mediated by volume loss.
Journal ArticleDOI
Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED.
Maurizio Zanobetti,Margherita Scorpiniti,Chiara Gigli,Peiman Nazerian,Simone Vanni,Francesca Innocenti,Valerio Stefanone,Caterina Savinelli,Alessandro Coppa,Sofia Bigiarini,Francesca Caldi,Irene Tassinari,Alberto Conti,Stefano Grifoni,Riccardo Pini +14 more
TL;DR: In this article, an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis, while maintaining an acceptable safety profile, which can help to stratify patients who should undergo a more detailed evaluation.
Journal ArticleDOI
Does inferior vena cava respiratory variability predict fluid responsiveness in spontaneously breathing patients
Norair Airapetian,Julien Maizel,Ola Alyamani,Yazine Mahjoub,Emmanuel Lorne,Mélanie Levrard,Nacim Ammenouche,Aziz Seydi,François Tinturier,Eric Lobjoie,Hervé Dupont,Michel Slama +11 more
TL;DR: In SBP with suspected hypovolemia, vena cava size and respiratory variability do not predict fluid responsiveness, and a cIVC >42 % may predict an increase in CO after fluid infusion.
References
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