OBJECTIVE: To investigate whether ultrasound determination of the inferior vena cava diameter (IVCD) and its collapsibility index (IVCCI) could be used to optimize the fluid removal rate while avoiding hypotension during slow continuous ultrafiltration (SCUF). METHODS: Twenty-four consecutive patients [13 men and 11 women, mean age 72 +/- 5 years; New York Heart Association (NYHA) functional classes III-IV] with acute decompensated heart failure (ADHF) and diuretic resistance were admitted to our 16-bed medical ICU. Blood pressure (BP), heart rate (HR), respiratory rate (RR), blood samples for hematocrit, creatinine, sodium, potassium, and arterial BGA plus lactate were obtained at baseline and than every 2 h from the beginning of SCUF. IVCD, assessed by M-mode subcostal echocardiography during spontaneous breathing, was evaluated before SCUF, at 12 h, and just after the cessation of the procedure. The IVCCI was calculated as follows: [(IVCD(max) - IVCD(min))/IVCD(max)] x 100. RESULTS: Mean UF time was 20.3 +/- 4.6 h with a mean volume of 287.6 +/- 96.2 ml h(-1) and a total ultrafiltrate production of 5,780.8 +/- 1,994.6 ml. No significant difference in MAP, HR, RR, and IVCD before and after UF was found. IVCCI increased significantly after UF (P < 0.001). Hypotension was observed only in those patients (2/24) who reached an IVCCI >30%. In all the other patients, a significant increase in IVCCI was obtained without any hemodynamic instability. CONCLUSION: IVC ultrasound is a rapid, simple, and non-invasive means for bedside monitoring of intravascular volume during SCUF and may guide fluid removal velocity.
OBJECTIVE: To investigate whether ultrasound determination of the inferior vena cava diameter (IVCD) and its collapsibility index (IVCCI) could be used to optimize the fluid removal rate while avoiding hypotension during slow continuous ultrafiltration (SCUF). METHODS: Twenty-four consecutive patients [13 men and 11 women, mean age 72 +/- 5 years; New York Heart Association (NYHA) functional classes III-IV] with acute decompensated heart failure (ADHF) and diuretic resistance were admitted to our 16-bed medical ICU. Blood pressure (BP), heart rate (HR), respiratory rate (RR), blood samples for hematocrit, creatinine, sodium, potassium, and arterial BGA plus lactate were obtained at baseline and than every 2 h from the beginning of SCUF. IVCD, assessed by M-mode subcostal echocardiography during spontaneous breathing, was evaluated before SCUF, at 12 h, and just after the cessation of the procedure. The IVCCI was calculated as follows: [(IVCD(max) - IVCD(min))/IVCD(max)] x 100. RESULTS: Mean UF time was 20.3 +/- 4.6 h with a mean volume of 287.6 +/- 96.2 ml h(-1) and a total ultrafiltrate production of 5,780.8 +/- 1,994.6 ml. No significant difference in MAP, HR, RR, and IVCD before and after UF was found. IVCCI increased significantly after UF (P < 0.001). Hypotension was observed only in those patients (2/24) who reached an IVCCI >30%. In all the other patients, a significant increase in IVCCI was obtained without any hemodynamic instability. CONCLUSION: IVC ultrasound is a rapid, simple, and non-invasive means for bedside monitoring of intravascular volume during SCUF and may guide fluid removal velocity.
Authors: Bradley A Bart; Andrew Boyle; Alan J Bank; Inder Anand; Maria Teresa Olivari; Mark Kraemer; Shari Mackedanz; Paul A Sobotka; Mike Schollmeyer; Steven R Goldsmith Journal: J Am Coll Cardiol Date: 2005-11-04 Impact factor: 24.094
Authors: Maria Rosa Costanzo; Maya E Guglin; Mitchell T Saltzberg; Mariell L Jessup; Bradley A Bart; John R Teerlink; Brian E Jaski; James C Fang; Erika D Feller; Garrie J Haas; Allen S Anderson; Michael P Schollmeyer; Paul A Sobotka Journal: J Am Coll Cardiol Date: 2007-01-26 Impact factor: 24.094
Authors: Antoine Vieillard-Baron; Michel Slama; Bernard Cholley; Gérard Janvier; Philippe Vignon Journal: Intensive Care Med Date: 2007-11-09 Impact factor: 17.440
Authors: Christophe Barbier; Yann Loubières; Christophe Schmit; Jan Hayon; Jean-Louis Ricôme; François Jardin; Antoine Vieillard-Baron Journal: Intensive Care Med Date: 2004-03-18 Impact factor: 17.440
Authors: R De Vecchis; A Ciccarelli; C Ariano; A Pucciarelli; C Cioppa; A Giasi; A Fusco; S Cantatrione Journal: Herz Date: 2010-10-28 Impact factor: 1.443
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; Herwig Gerlach; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Jean-Charles Preiser; Jerôme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2011-01-12 Impact factor: 17.440
Authors: Silke de Valk; Tycho Joan Olgers; Mirjam Holman; Farouq Ismael; Jack Johannes Maria Ligtenberg; Jan Cornelis Ter Maaten Journal: BMC Anesthesiol Date: 2014-12-12 Impact factor: 2.217
Authors: Laurent Muller; Xavier Bobbia; Mehdi Toumi; Guillaume Louart; Nicolas Molinari; Benoit Ragonnet; Hervé Quintard; Marc Leone; Lana Zoric; Jean Yves Lefrant Journal: Crit Care Date: 2012-10-08 Impact factor: 9.097