Caval Aorta Index and Central Venous Pressure Correlation in Assessing Fluid Status! “Ultrasound Bridging the Gap”

Harshitha Sridhar,V P Chandrasekaran,Pavan Mangalore,Rishya Manikam

doi:10.5402/2012/828626

Harshitha Sridhar, V P Chandrasekaran + Show 2 more

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https://doi.org/10.5402/2012/828626

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Abstract

Accurate body fluid assessment and estimation of fluid status are essential in guiding fluid therapy in emergency setup. This prospective cross-sectional descriptive study conducted to ascertain the effectiveness of inferior vena cava and aorta (IVC/Aorta) index in assessing the fluid status by comparing it with the central venous pressure (CVP). Results showed the mean IVC/Aorta index in patients who had normal CVP range was 1.2 ± 0.12 SD, while in patients with low CVP, the mean index was 0.7 ± 0.09 SD, and, patients with high CVP, the mean index was 1.6 ± 0.05 SD. In conclusion, the sonographic IVC/Aorta index assessment seems to be a quick, simple, noninvasive, and reliable method to access the fluid status in a busy setup like an emergency room.

Highlights

Physicians need to understand, evaluate, and address the hemodynamics in every patient, especially for patients in the emergency room (ER) and intensive care units (ICU)
While the patient lies supine, the central venous pressure (CVP) was noted using a standard manometer at random time by an emergency physician (EP1), and simultaneous sonographic assessment of the inferior vena cava (IVC) and aorta diameters was conducted by the second emergency physician [EP2]
This study consists of 170 patients (Figure 1) of an average age 40 ± 11 years with a male female ratio of 3.2 : 1. Sepsis was the prevailing diagnosis (Figure 2); 84% cases had CVP 13 cm H2O

Summary

Introduction

There are various techniques for assessing the fluid status such as clinical examination, central venous pressure (CVP) measurement, biochemical markers, bioimpedance, continuous blood volume measurement, or sonographic inferior vena cava (IVC) diameter assessment. All of these methods have some limitations when used in clinical practice [2,3,4]. If this study can establish that sonographic evaluation of the IVC can predict the volume status, this tool can assist emergency physicians in rapid diagnosis and prompt resuscitation of patients, especially for those who present in hypovolemic shock. The aim is to study the effectiveness of inferior vena cava/aorta index (IVC/Ao) in assessing the fluid status by comparing it with the CVP

Materials and Methodology

Results

Discussion