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Relationship between inferior vena cava diameter ratio and central venous pressure
Author(s) -
Zhang Qing,
Wang Xiaoting,
Su Longxiang,
Zhang Hongmin,
Chai Wenzhao,
Chao Yangong,
He Wei,
Liu Dawei
Publication year - 2018
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22586
Subject(s) - medicine , inferior vena cava , central venous pressure , ultrasonography , expiration , anesthesia , nuclear medicine , surgery , blood pressure , heart rate , respiratory system
Purpose To explore the relationship between the shape of the inferior vena cava (IVC) lumen and central venous pressure (CVP). Methods In 60 patients undergoing mechanical ventilation and CVP monitoring in the Intensive Care Unit of Peking Union Medical College Hospital from July to October 2016, we measured with B‐mode ultrasonography the transverse maximum (MXD) and minimum diameter (MID) of the IVC at end expiration, and calculated the diameter ratio (DR) as MXD/MID. Patients were divided into three groups according to CVP: low (CVP < 8 mm Hg), intermediate (8 mm Hg ≤ CVP ≤ 10 mm Hg), and high (CVP > 10 mm Hg). Results MXD was 2.32 ± 0.41 cm, MID was 1.41 ± 0.40 cm, and DR was 1.76 ± 0.49. CVP was 9.27 ± 2.99 mm Hg. DR correlated with CVP (r = −0.527, P < .001). The low‐CVP group had greater dispersion of DR values, with a large variety in IVC shape (elliptical, irregular, teardrop‐shaped, partially collapsed…). The area under the ROC curve for predicting CVP with DR, with a CVP threshold of 8 mm Hg was 0.835 (95% CI, 0.726–0.945; P < .05). With a DR cutoff value of 1.76, sensitivity was 0.765 and specificity was 0.781. Conclusions DR above 1.7 is predictive of CVP < 8 mm Hg.