JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2014, Vol. 52 ›› Issue (10): 96-99.doi: 10.6040/j.issn.1671-7554.0.2014.278

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Role of ultrasound guided measurement of inferior vena cava and right ventricular diameters in the assessment of volume status in elderly patients

ZHU Lei, ZHAO Zhibin, FENG Jiying, ZHU Pin, LUAN Hengfei, ZHANG Xiaobao   

  1. Department of Anesthesiology, First People's Hospital of Lianyungang, Lianyungang 222000, Jiangsu, China
  • Received:2014-04-29 Revised:2014-06-17 Online:2014-10-10 Published:2014-10-10

Abstract: Objective To evaluate inferior vena cava (IVC) and right ventricular (RV) diameters and their correlations with central venous pressure (CVP) for rapid evaluation of blood volume in elderly patients. Methods A total of 40 elderly patients with preoperative fasting (experimental group) and 30 healthy elderly volunteers (control group) were enrolled in the study. The heart rate (HR), oxygen saturation (SpO2), mean arterial pressure (MAP) of patients were recorded after they were sent to the operating room. The IVC diameters during expiration (IVCe) and inspiration (IVCi), and the maximum RV diameter were measured with ultrasonography both before and after fluid resuscitation. The CVP was measured under local anesthesia. The HR, SpO2, MAP, IVC and RV of controls were measured during the time they participated in the study. Results The average diameters of the IVCe, IVCi, and RV in patients were significantly lower compared with healthy controls (P<0.01), while IVC-CI of patients was higher than that of controls. After fluid resuscitation, IVCe was increased by 46.5% and IVCi by 85.9%, which were positively correlatedwith synchronous CVP (r=0.598); IVC-CI was reduced by 31.7%, which was negatively correlated with CVP (r=-0.418). Conclusion The IVC and RV are consistently low in hypovolemic elderly patients when compared with healthy controls. Ultrasonographic measurements of IVC and RV diameters could be a useful noninvasive tool for the detection and follow-up of elderly patients with hypovolemia.

Key words: Elderly patients, Inferior vena cava, Volume status, Ultrasound, Right ventricular

CLC Number: 

  • R445.1
[1] Blehar D J, Dickman E, Gaspari R. Identification of congestive heart failure via respiratory variation of inferior vena cava diameter[J]. Am J Emerg Med, 2009, 27(1): 71-75.
[2] Seif D, Mailhot T, Perera P, et al. Caval sonography in shock: a noninvasive method for evaluating intravascular volume in critically ill patients[J]. J Ultrasound Med, 2012, 31(12): 1885-1890.
[3] Panchal S, Nagori C. Imaging techniques for assessment of tubal status[J]. J Hum Reprod Sci, 2014, 7(1): 2-12.
[4] 刘拴虎, 刘雅丽, 刘阳, 等. 超声探测下腔静脉快速评估高龄脓毒症休克患者血容量的价值[J]. 中华老年医学杂志, 2013, 33(13): 3210-3211. LIU Shuanhu, LIU Yali, LIU Yang, et al. The value of ultrasonic detection of inferior vena cava for evaluating intravascular volume in elderly patients with septic shock[J]. Chinese Journal of Gerontology, 2013, 33(13): 3210-3211.
[5] Marik P E, Cavallazzi R. Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense[J]. Crit Care Med, 2013, 41(7): 1774-1781.
[6] 商娜, 周荣斌. 容量负荷评估指标研究进展[J]. 实用医学杂志, 2013, 29(2): 169-170. SHANG Na, ZHOU Rongbin. Research progress of volume load evaluation[J]. The Journal of Practical Medicine, 2013, 29(2): 169-170.
[7] 谢海, 李艳, 陈勇, 等. 中心静脉压与每搏变异度的关系[J]. 山东医药, 2013, 53(16):71-72. XIE Hai, LI Yan, CHEN Yong, et al. The relationship between central venous pressure and stroke volume variation[J]. Shandong Medical Journal, 2013, 53(16): 71-72.
[8] 庄燕, 王醒. 超声心动图在重症患者容量状态评估中的应用[J]. 东南大学学报: 医学版, 2013, 32(1): 125-127. ZHUANG Yan, WANG Xin. The volume assessment in critical ill patients with echocardiography[J]. Journal of Southeast University: Medical Science Edition, 2013, 32(1):125-127.
[9] 毛艳卿, 喻晓东, 李扬麟, 等. 血液透析患者下腔静脉直径/体表面积变化及意义[J]. 山东医药, 2014, 54(3): 20-22. MAO Yanqing, YU Xiaodong, LI Yanglin, et al. Changes and significance of inferior vena cava diameter/body surface area in patients under treatment of hemodialysis[J]. Shandong Medical Journal, 2014, 54(3): 20-22.
[10] 尹万红, 陈瑶, 金晓东, 等. 床旁超声监测颈总动脉峰流速变异用于评估外科ICU患者容量状态的研究[J]. 四川大学学报: 医学版, 2013, 44(4): 624-628. YIN Wanhong, CHEN Yao, JING Xiaodong, et al. Measurement of peak velocity variation of common carotid artery with bedside ultrasound to estimate preload in surgery ICU[J]. Journal of Sichuan University: Medical Science Edition, 2013, 44(4):624-628.
[11] Stawicki S P, Braslow B M, Panebianco N L, et al. Intensivist use of hand-carried ultrasonography to measure IVC collapsibility in estimating intravascular volume status: correlations with CVP[J]. J Am Coll Surg, 2009, 209(1): 55-61.
[12] Ferrada P, Anand R J, Whelan J, et al. Qualitative assessment of the inferior vena cava: useful tool for the evaluation of fluid status in critically ill patients[J]. Am Surg, 2012, 78(4): 468-470.
[13] Zengin S, Al B, Genc S, et al. Role of inferior vena cava and right ventricular diameter in assessment of volume status: a comparative study: ultrasound and hypovolemia[J]. Am J Emerg Med, 2013, 31(5): 763-767.
[14] Juhl-Olsen P, Frederiksen C A, Sloth E. Ultrasound assessment of inferior vena cava collapsibility is not a valid measure of preload changes during triggered positive pressure ventilation: a controlled cross-over study[J]. Ultraschall Med, 2012, 33(2): 152-159.
[15] Ng L, Khine H, Taragin B H. Does bedside sonographic measurement of the inferior vena cava diameter correlate with central venous pressure in the assessment of intravascular volume in children?[J] Pediatr Emerg Care, 2013, 29(3): 337-341.
[16] 刘笑雷, 顾承东, 王海峰, 等. 老年脓毒症休克患者下腔静脉管径和呼吸变异指数与中心静脉压的关系[J]. 中华老年医学杂志, 2012, 31(2): 132-135. LIU Xiaolei, GU Chendong, WANG Haifeng, et al. Correlation of radius and respiration variation of inferior vena cava with central venous pressure in elderly patiens with septic shock[J]. Chinese Journal of Gerontology, 2012, 31(2): 132-135.
[17] Holte K, Kehlet H. Compensatory fluid administration for preoperative dehydration-does it improve outcome?[J] Acta Anaesthesiol Scand, 2002, 46(9): 1089-1093.
[18] 朱伟, 徐义国, 桂煜, 等. 麻醉诱导期不同容量羟乙基淀粉对胸外科老年患者凝血功能的影响[J]. 中国药业, 2013, 22(4):28-29. ZHU Wei, XU Yiguo, GUI Huang, et al. The effects of anesthesia induction period with different hydroxyethyl starch on coagulation function in older patients in Department of thoracic surgery[J]. China Pharmaceuticals, 2013, 22(4):28-29.
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