![]() ![]() It might be better to measure IVCD using a method that avoids the diaphragm to accurately estimate RAP. The high-echo structure pushing the IVC from the back is the diaphragm in most patients. The sensitivity of IVCD to predict RAP ≥ 10 mmHg (IVCDmax > 21 mm, IVCCI < 50%) increased from 31.3% to 68.8% with our method. In those patients, when IVCs were measured in a way that avoided the diaphragm, IVCDmax diameter was larger and IVC collapsibility index (IVCCI) tended to be smaller than those when IVCDs were measured according to the guideline methods. ResultsĬT scans revealed that the diaphragm, not the vertebra, was located just behind the IVC in most patients. We reviewed computed tomography (CT) scans and analyzed the relation between RAP and IVCD measured by echocardiography not only in the way recommended in the guidelines, but also in a way that avoided the structure. We retrospectively studied 116 patients who underwent right-heart catheterization. The aim of this study was to identify the structure behind the IVC and to evaluate its influence on RAP. However, right atrial pressure (RAP) is underestimated in some patients who have a small IVC diameter (IVCD) because of a high-echo structure compressing the IVC from the back at that portion. Further study may be undertaken to determine the relationship of unit change of IVCd due to acute blood loss in case of trauma or other conditions.It is recommended in current guidelines that the inferior vena cava (IVC) diameter should be measured at 1.0–2.0 cm from the junction with the right atrium. Thus, the acute depletion of CBV could be detected by measuring the change of IVCd by sonography. The decrease in INV diameter following blood loss was significant (p< 0.01). Likewise, the mean diameter of IVC during inspiration before and after the blood donation was 12.96mm (☑.61mm) and 7.58mm (☑.29mm) respectively. The mean diameter of IVC during expiration before and after the blood donation was 17.5mm (☑.56mm) and 11.93mm (☑.48mm) respectively. In sagittal sections, the inferior vena cava behind the liver were imaged during inspiration and expiration. During examination, the transducer was applied to the epigastrium parallel to the median line about 2 cm to the right of it for sagittal sections, and at a right angle to the median line about 3 cm below the xiphoid process for transverse sections. The inferior vena cava diameters, both during inspiration and expiration were measured by ultrasound examination immediately before and after donation of a single unit (450ml) of blood. A total of 50 volunteer blood donors aged 18 to 57 years were studied in the Department of Radiology and Imaging of Dhaka Medical College Hospital (DMCH) from July 2004 to June 2005. The present study was designed to determine whether acute blood loss could be detected by sonographic measurement of the IVCd. Ultrasonographic measurement of IVCd provides a noninvasive real-time information of the CBV. Change in the inferior vena cava diameter (IVCd) occurs due to alteration in circulating blood volume (CBV) and blood loss. Department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhakaĭepartment of Radiology and Imaging, Dhaka Medical College & Hospital, Dhakaĭetection and monitoring of blood loss in trauma patients can often be challenging. ![]()
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