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  1. Article ; Online: Inferior Vena Cava Measurement with Ultrasound: What Is the Best View and Best Mode?

    Finnerty, Nathan M / Panchal, Ashish R / Boulger, Creagh / Vira, Amar / Bischof, Jason J / Amick, Christopher / Way, David P / Bahner, David P

    The western journal of emergency medicine

    2017  Volume 18, Issue 3, Page(s) 496–501

    Abstract: ... for B-mode and M-mode measurements. Post-hoc analyses revealed difficulty in consistent view acquisition ... for all M-mode IVCCI were low. Significant interaction effects between anatomical view and EP were observed ... of intravascular volume assessment via examination of the inferior vena cava (IVC). However, there are limited data ...

    Abstract Introduction: Intravascular volume status is an important clinical consideration in the management of the critically ill. Point-of-care ultrasonography (POCUS) has gained popularity as a non-invasive means of intravascular volume assessment via examination of the inferior vena cava (IVC). However, there are limited data comparing different acquisition techniques for IVC measurement by POCUS. The goal of this evaluation was to determine the reliability of three IVC acquisition techniques for volume assessment: sub-xiphoid transabdominal long axis (LA), transabdominal short axis (SA), and right lateral transabdominal coronal long axis (CLA) (aka "rescue view").
    Methods: Volunteers were evaluated by three experienced emergency physician sonographers (EP). Gray scale (B-mode) and motion-mode (M-mode) diameters were measured and IVC collapsibility index (IVCCI) calculated for three anatomic views (LA, SA, CLA). For each IVC measurement, we calculated descriptive statistics, intra-class correlation coefficients (ICC), and two-way univariate analyses of variance.
    Results: EPs evaluated 39 volunteers, yielding 351 total US measurements. Measurements of the three views had similar means (LA 1.9 ± 0.4cm; SA 1.9 ± 0.4cm; CLA 2.0 ± 0.5cm). For B-Mode, LA had the highest ICC (0.86, 95% CI [0.76-0.92]) while CLA had the poorest ICC (0.74, 95% CI [0.56-0.85]). ICCs for all M-mode IVCCI were low. Significant interaction effects between anatomical view and EP were observed for B-mode and M-mode measurements. Post-hoc analyses revealed difficulty in consistent view acquisition between EPs.
    Conclusion: Inter-rater reliability of the IVC by EPs was highest for B-mode LA and poorest for all M-Mode IVC collapsibility indices (IVCCI). These results suggest that B-mode LA holds the most promise to deliver reliable measures of IVC diameter. Future studies may focus on validation in a clinical setting as well as comparison to a reference standard.
    Language English
    Publishing date 2017-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2375700-0
    ISSN 1936-9018 ; 1936-900X
    ISSN (online) 1936-9018
    ISSN 1936-900X
    DOI 10.5811/westjem.2016.12.32489
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Inferior Vena Cava Measurement With Ultrasound

    Nathan M. Finnerty / Ashish R. Panchal / Creagh Boulger / Amar Vira / Jason J. Bischof / Christopher Amick / David P. Way / David P. Bahner

    Western Journal of Emergency Medicine, Vol 18, Iss 3, Pp 496-

    What is The Best View and Best Mode?

    2017  Volume 501

    Abstract: ... for B-mode and M-mode measurements. Post-hoc analyses revealed difficulty in consistent view acquisition ... for all M-mode IVCCI were low. Significant interaction effects between anatomical view and EP were observed ... of intravascular volume assessment via examination of the inferior vena cava (IVC). However, there are limited data ...

    Abstract Introduction: Intravascular volume status is an important clinical consideration in the management of the critically ill. Point-of-care ultrasonography (POCUS) has gained popularity as a non-invasive means of intravascular volume assessment via examination of the inferior vena cava (IVC). However, there are limited data comparing different acquisition techniques for IVC measurement by POCUS. The goal of this evaluation was to determine the reliability of three IVC acquisition techniques for volume assessment: subxiphoid transabdominal long axis (LA), transabdominal short axis (SA), and right lateral transabdominal coronal long axis (CLA) (aka “rescue view”). Methods: Volunteers were evaluated by three experienced emergency physician sonographers (EP). Gray scale (B-mode) and motion-mode (M-mode) diameters were measured and IVC collapsibility index (IVCCI) calculated for three anatomic views (LA, SA, CLA). For each IVC measurement, we calculated descriptive statistics, intra-class correlation coefficients (ICC), and two-way univariate analyses of variance. Results: EPs evaluated 39 volunteers, yielding 351 total US measurements. Measurements of the three views had similar means (LA 1.9 ± 0.4cm; SA 1.9 ± 0.4cm; CLA 2.0 ± 0.5cm). For B-Mode, LA had the highest ICC (0.86, 95% CI [0.76-0.92]) while CLA had the poorest ICC (0.74, 95% CI [0.56-0.85]). ICCs for all M-mode IVCCI were low. Significant interaction effects between anatomical view and EP were observed for B-mode and M-mode measurements. Post-hoc analyses revealed difficulty in consistent view acquisition between EPs. Conclusion: Inter-rater reliability of the IVC by EPs was highest for B-mode LA and poorest for all M-Mode IVC collapsibility indices (IVCCI). These results suggest that B-mode LA holds the most promise to deliver reliable measures of IVC diameter. Future studies may focus on validation in a clinical setting as well as comparison to a reference standard. [West J Emerg Med. 2017;18(3)496-501.]
    Keywords Inferior vena cava ; Point-of-care ; Ultrasonography ; Variation in inferior vena cava ; Critical illness ; Fluid responsiveness ; Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
    Language English
    Publishing date 2017-04-01T00:00:00Z
    Publisher eScholarship Publishing, University of California
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: Inter-rater reliability of sonographic measurements of the inferior vena cava.

    Saul, Turandot / Lewiss, Resa E / Langsfeld, Alexis / Radeos, Michael S / Del Rios, Marina

    The Journal of emergency medicine

    2012  Volume 42, Issue 5, Page(s) 600–605

    Abstract: ... volume status by examining measurements of the inferior vena cava (IVC). Many previous studies do not ... Three physicians visualized the IVC in three common views and utilized M-mode to measure the maximal and ... Background: Bedside ultrasound is emerging as a useful tool in the assessment of intravascular ...

    Abstract Background: Bedside ultrasound is emerging as a useful tool in the assessment of intravascular volume status by examining measurements of the inferior vena cava (IVC). Many previous studies do not fully describe their scanning protocol.
    Objectives: The objective of this study was to evaluate which of three commonly reported IVC scanning methods demonstrates the best inter-rater reliability.
    Methods: Three physicians visualized the IVC in three common views and utilized M-mode to measure the maximal and minimal diameter during quiet respiration. Pairwise correlation coefficients were determined using Pearson product-moment correlation.
    Results: The most reliable pair of measurements (inspiratory and expiratory) was found to be using the anterior midaxillary line longitudinal view with a Kappa value for both at 0.692.
    Conclusion: Imaging with the anterior midaxillary longitudinal approach using the liver as an acoustic window provides the best inter-rater reliability when measuring the IVC. Our findings demonstrate that IVC measurements differ based on anatomic location.
    MeSH term(s) Adult ; Humans ; Observer Variation ; Point-of-Care Systems/standards ; Prospective Studies ; Ultrasonography/methods ; Vena Cava, Inferior/diagnostic imaging
    Language English
    Publishing date 2012-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2011.05.095
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1895: Show issues Location:
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  4. Article ; Online: Best approach to measuring the inferior vena cava in spontaneously ventilating patients: a pilot study.

    Baker, Elinor C / Pott, Jason / Khan, Faisal / Freund, Yonathan / Harris, Tim

    European journal of emergency medicine : official journal of the European Society for Emergency Medicine

    2015  Volume 22, Issue 1, Page(s) 58–61

    Abstract: ... mode height and ellipse circumference) during inspiration and expiration, and inferior vena cava ... of inferior vena cava (IVC) size and respiratory variation in response to changes in circulating volume. Transabdominal ... ultrasound measurements of the IVC were obtained in longitudinal (B and M modes) and transverse planes (B ...

    Abstract The objective of this study was to establish the reliability of different measurements of inferior vena cava (IVC) size and respiratory variation in response to changes in circulating volume. Transabdominal ultrasound measurements of the IVC were obtained in longitudinal (B and M modes) and transverse planes (B-mode height and ellipse circumference) during inspiration and expiration, and inferior vena cava collapsibility indices (IVCci) were calculated. Measurements were repeated following venesection of ∼450 ml. Thirty patients underwent venesection. Their IVCci increased significantly for transverse and longitudinal height measurements following venesection, but not for transverse circumference measurements. Transverse views were inadequate in 27% of patients, compared with 7% for longitudinal views (P=0.04). Changes in IVCci are sensitive to small changes in circulating volume. Measurements are most frequently achieved in the longitudinal plane. There is an urgent need for standardization of sonographic IVC measurement techniques.
    MeSH term(s) Blood Volume ; Exhalation/physiology ; Female ; Humans ; Inhalation/physiology ; Male ; Middle Aged ; Organ Size ; Phlebotomy ; Pilot Projects ; Prospective Studies ; Ultrasonography ; Vena Cava, Inferior/anatomy & histology ; Vena Cava, Inferior/diagnostic imaging
    Language English
    Publishing date 2015-02
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 1233544-7
    ISSN 1473-5695 ; 0969-9546
    ISSN (online) 1473-5695
    ISSN 0969-9546
    DOI 10.1097/MEJ.0000000000000148
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4264: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
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