inferior vena cava and hemodynamic congestion
نویسندگان
چکیده
conclusions the abovementioned ivc ultrasonographic criteria for hemodynamic congestion appear clearly inconsistent. alternatively, a sequential or simultaneous combination of clinical scores of congestion, ivc ultrasonographic indices, and circulating levels of natriuretic peptides could be warranted. background among the indices able to replace invasive central venous pressure (cvp) measurement for patients with acute decompensated heart failure (adhf) the diameters of the inferior vena cava (ivc) and their respiratory fluctuations, so-called ivc collapsibility index (ivcci), measured by echocardiography, have recently gained ground as a quite reliable proxy of cvp. objectives the aims of our study were to compare three different ways of evaluating cardiac overload by using the ivc diameters and/or respiratory fluctuations and by calculating the inter-method agreement patients and methods medical records of patients hospitalized for right or bi-ventricular acute decompensated heart failure from january to december 2013 were retrospectively evaluated. the predictive significance of the ivc expiratory diameter and ivc collapsibility index (ivcci) was analyzed using three different methods, namely a) the criteria for the indirect estimate of right atrial pressure by rudski et al. (j am soc echocardiogr. 2010); b) the categorization into three ivcci classes by stawicki et al. (j am coll surg. 2009); and c) the subdivision based on the value of the maximum ivc diameter by pellicori et al. (jacc cardiovasc imaging. 2013). results among forty-seven enrolled patients, those classified as affected by persistent congestion were 22 (46.8%) using rudski’s criteria, or 16 (34%) using stawicki’s criteria, or 13 (27.6%) using pellicori’s criteria. the inter-rater agreement was rather poor by comparing rudski’s criteria with those of stawicki (cohen’s kappa = 0.369; 95% ci 0.197 to 0.54), as well as by comparing rudski’s criteria with those of pellicori (cohen’s kappa = 0.299; 95% ci 0.135 to 0.462). further, a substantially unsatisfactory concordance was also found for stawicki’s criteria compared to those of pellicori (cohen’s kappa= 0.468; 95% ci 0.187 to 0.75).
منابع مشابه
Inferior Vena Cava and Hemodynamic Congestion
BACKGROUND Among the indices able to replace invasive central venous pressure (CVP) measurement for patients with acute decompensated heart failure (ADHF) the diameters of the inferior vena cava (IVC) and their respiratory fluctuations, so-called IVC collapsibility index (IVCCI), measured by echocardiography, have recently gained ground as a quite reliable proxy of CVP. OBJECTIVES The aims of...
متن کاملPerforation of Inferior Vena Cava by Inferior Vena Cava Filter
Supervising Section Editor: Sean O. Henderson, MD Submission history: Submitted June 13, 2012; Accepted August 6, 2012 Full text available through open access at http://escholarship.org/uc/uciem_westjem DOI: 10.5811/westjem.2012.8.12795 [West J Emerg Med 2013;14(2):161-162.] Sarah Unterman, MD* Tad Nair, MD† Jesse Brown VA Medical Center, Department of Emergency Medicine, Chicago, Illinois Univ...
متن کاملDouble inferior vena cava.
Venous anomalies involving the inferior vena cava are very rare. The case of a 74-year-old man with coronary artery disease is presented. Interestingly, a double inferior vena cava was incidentally discovered during coronary artery bypass grafting. Persistence of the left hepatic segment vein appeared as a left inferior vena cava-a very rare condition.
متن کاملInferior vena cava filters.
Venous thromboembolism is common. Most pulmonary emboli arise as thromboses in the deep veins of the lower extremities and may result in serious complications. Inferior vena cava filters (IVCF) are intended to prevent the passage of deep vein thrombosis to the pulmonary arteries. Accepted indications for IVCF placement include the presence of acute venous thromboembolism with inability to admin...
متن کاملInferior Vena Cava Thrombosis.
Thrombosis of the inferior vena cava (IVC) is an under-recognized entity that is associated with significant short- and long-term morbidity and mortality. In absence of a congenital anomaly, the most common cause of IVC thrombosis is the presence of an unretrieved IVC filter. Due to the substantial increase in the number of IVC filters placed in the United States and the very low filter retriev...
متن کاملمنابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
research in cardiovascular medicineجلد ۴، شماره ۳، صفحات ۰-۰
میزبانی شده توسط پلتفرم ابری doprax.com
copyright © 2015-2023