Original scientific articleIntensivist Use of Hand-Carried Ultrasonography to Measure IVC Collapsibility in Estimating Intravascular Volume Status: Correlations with CVP
Section snippets
Methods
A prospective evaluation of cardiac and hemodynamic status was conducted on 124 surgical intensive care unit (SICU) patients using a hand-carried ultrasonography unit (MicroMaxx with P17 1 to 5 MHz phased array probe; Sonosite). Evaluation included IVC assessment and evaluation of the heart for left ventricular ejection fraction, mitral valve inflow and tissue Doppler measurements, and cardiac filling.
Intensivist sonographers included emergency medicine faculty, emergency medicine
Results
The study was performed in a high-acuity combined trauma, general surgery, gynecology, otolaryngology, and thoracic SICU. A total of 124 patients were prospectively enrolled between October 2006 and April 2007. Of those patients, 101 had central venous catheters. This group consisted of 46 women and 55 men, with mean age of 58.3 ± 18.6 years (median age 60.5 years, range 21 to 85 years) and mean left ventricular ejection fraction of 61.5% by full-feature echocardiography. Among these patients,
Discussion
Assessment of intravascular volume status is an essential component of the care of critically ill patients. A variety of devices and parameters, including pulmonary artery catheter, CVP, esophageal Doppler, arterial waveform analysis, and mitral valve inflow and tissue Doppler have been advocated for this purpose.23 This range of options reflects the fact that that no single method is universally accepted. Likewise, each form of monitoring has its own spectrum of risks and benefits,1, 24, 25, 26
Author Contributions
Study conception and design: Stawicki, Kirkpatrick, Gracias, Dean
Acquisition of data: Panebianco, Hayden, Dean
Analysis and interpretation of data: Stawicki, Panebianco, Kirkpatrick, Hayden, Dean
Drafting of manuscript: Stawicki, Braslow, Panebianco, Gracias, Dean
Critical revision: Stawicki, Kirkpatrick, Gracias, Hayden, Dean
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