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Best approach to measuring the inferior vena cava in spontaneously ventilating patients: a pilot study

Baker, Elinor C.a; Pott, Jasona; Khan, Faisala; Freund, Yonathana,b; Harris, Tima,b

European Journal of Emergency Medicine: February 2015 - Volume 22 - Issue 1 - p 58–61
doi: 10.1097/MEJ.0000000000000148

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.

aEmergency Department, Royal London Hospital, Barts Health NHS Trust

bEmergency Department, Barts Health NHS Trust, Whipps Cross University Hospital, London, UK

Correspondence to Elinor C. Baker, MBBS, MPH, c/o Jason Pott, Emergency Department Research Office, Royal London Hospital, Whitechapel Road, London E1 1BB, UK Tel: +44 203 594 0045; e-mail:

Received October 27, 2013

Accepted March 6, 2014

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