Correlation Between Sonographic Inferior Vena Cava/Aorta Diameter Index and Central Venous Pressure

Yang,  Jung Il; Han,  Kyu Hong; Cho,  Sung Uk; Lee,  Seung Han; You,  Yeon Ho; Ryu,  Seung; Lee,  Jin Woong; Kim,  Seung Whan; Yoo,  In Sool

J Korean Soc Emerg Med > Volume 21(3); 2010 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2010;21(3): 341-346.

Correlation Between Sonographic Inferior Vena Cava/Aorta Diameter Index and Central Venous Pressure

Jung Il Yang, Kyu Hong Han, Sung Uk Cho, Seung Han Lee, Yeon Ho You, Seung Ryu, Jin Woong Lee, Seung Whan Kim, In Sool Yoo

Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Korea. rs0505@cnuh.co.kr

ABSTRACT

PURPOSE:
Body fluid status of patients in an emergency room environment is a very important parameter during clinical evaluation. In this study, we wanted to know the relationship between the diameter of the inferior vena cava and the diameter of the (IVC/Ao index) and central venous pressure (CVP) in hemodynamically unstable patients.
METHODS:
This study was done prospectively in an emergency medical center of a hospital from January to August, 2009. We compared the diameter of the IVC, the diameter of inferior vena cava/the body surface area index (IVC/BSA index), the IVC/Ao index, and other variables. Before and after hydration of patients with a systolic blood pressure less than 90 mmHg and who had a central venous catheter in place. Then, we calculated the correlation coefficient for DeltaCVP, DeltaIVC/Ao index, and other indexes.
RESULTS:
Fifty-nine patients were enrolled in the study. The mean IVC diameter before hydration was 14.3+/-2.7 mm; it was 15.6+/-2.7 mm after hydration (p<0.01). The IVC/BSA index before hydration was 8.75+/-1.72 and 9.55+/-1.79 after hydration (p<0.01). The IVC/Ao index before hydration was 1.08+/-0.23; it was 1.16+/-0.25 after hydration (p<0.01). The correlation coefficient for DeltaCVP and DeltaIVC was 0.37 (p<0.01); for DeltaCVP vs. the DeltaIVC/BSA index it was 0.37 (p<0.01); for the DeltaIVC/Ao index it was 0.27 (p=0.04).
CONCLUSION:
CVP has a higher correlation to IVC diameter and to IVC/BSA index than to the IVC/Ao index. Hence, we should estimate the IVC/Ao index and use that estimate along with other indexes to evaluate body fluid status when dealing with hemodynamically unstable patients.

Key words: Inferior vena cava, Central venous pressure, Ultrasonography