Cardiac variation of inferior vena cava: new concept in the evaluation of intravascular blood volume

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• 作者：Kensuke Nakamura (1)
  Makoto Tomida (2)
  Takehiro Ando (2)
  Kon Sen (2)
  Ryota Inokuchi (1)
  Etsuko Kobayashi (2)
  Susumu Nakajima (1)
  Ichiro Sakuma (2)
  Naoki Yahagi (1)
  
• 关键词：IVC cardiac variation ; Ultrasound ; Snakes ; Speckle tracking ; IVC respiratory variation
• 刊名：Journal of Medical Ultrasonics
• 出版年：2013
• 出版时间：July 2013
• 年：2013
• 卷：40
• 期：3
• 页码：205-209
• 全文大小：312KB
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• 作者单位：Kensuke Nakamura (1)
  Makoto Tomida (2)
  Takehiro Ando (2)
  Kon Sen (2)
  Ryota Inokuchi (1)
  Etsuko Kobayashi (2)
  Susumu Nakajima (1)
  Ichiro Sakuma (2)
  Naoki Yahagi (1)
  
  1. Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo Bunkyo, Tokyo, 113-8655, Japan
  2. Department of Precision Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo Bunkyo, Tokyo, 113-8656, Japan
  

文摘

Evaluation of the intravascular blood volume is an important assessment in emergency and critical care medicine. Measurement of the inferior vena cava (IVC) respiratory variation by ultrasound echography is useful, but it entails subjective problems. We have hypothesized that IVC cardiac variation is also correlated with intravascular blood volume and analyzed it automatically using computer software of two kinds, later comparing the results. Snakes, software to track boundaries by curve line continuity, and template matching software were incorporated into a computer with an ultrasound machine to track the short-axis view of IVC automatically and analyze it with approximation by ellipse. Eight healthy volunteers with temporary mild hypovolemia underwent echography before and after passive leg raising and while wearing medical anti-shock trousers. IVC cardiac variation was visually decreased by both leg raising and medical anti-shock trousers. The collapse index (maximum???minimum/maximum) of area during three cardiac beats was decreased showing a good relationship to fluid load simulations; 0.24?±?0.03 at baseline versus 0.11?±?0.01 with leg raising and 0.12?±?0.01 with medical anti-shock trousers. In conclusion, IVC cardiac variation has the potential to provide an evaluation of water volume. It presents some advantages in mechanical analysis over respiratory variation. At the very least, we need to exercise some caution with cardiac variation when evaluating respiratory variation.