Inferior vena cava ultrasound and other techniques for assessment of intravascular and extravascular volume: an update

Abstract Goals of volume management are to accurately assess intravascular and extravascular predict response administration, vasopressor support, or removal. Data reviewed that support the following: 1) Dynamic parameters reliably guide administration may improve clinical outcomes compared static parameters, but some invasive only validated with mechanical ventilation without spontaneous breathing. 2) Ultrasound visualization inferior vena cava (IVC) diameter variations respiration assesses predicts responsiveness. 3) Although physiology IVC respiratory differs breathing, collapsibility index (CI) distensibility interconvertible. 4) Prediction responsiveness by CI is comparable for breathing patients. 5) Respiratory subclavian/proximal axillary internal jugular veins ultrasound alternative sites, reliability. 6) applicability hypotension anesthesia, ultrafiltration goals, dry weight, intra-dialytic hypotension, acute decompensated heart failure. 7) complement heart, lungs, abdominal organs venous congestion, assessing managing overload deresuscitation, renal failure, shock. 8) has limitations including inadequate visualization. data should always be interpreted in context. Additional studies required further validate role bedside ultrasonography care.