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The effect of continuous positive airway pressure on inferior vena cava collapsibility as measured by bedside ultrasound
OBJECTIVES: The purpose of this study was to determine the impact of progressively increasing continuous positive airway pressure (CPAP) on measurements of the caval index (CI) using bedside ultrasound at the 3 common inferior vena cava (IVC) evaluation sites. METHODS: This was a prospective, observ...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716031/ https://www.ncbi.nlm.nih.gov/pubmed/36474708 http://dx.doi.org/10.1002/emp2.12856 |
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author | Solis‐McCarthy, Jessica Gelabert, Christopher Michalek, Joel Sisson, Craig |
author_facet | Solis‐McCarthy, Jessica Gelabert, Christopher Michalek, Joel Sisson, Craig |
author_sort | Solis‐McCarthy, Jessica |
collection | PubMed |
description | OBJECTIVES: The purpose of this study was to determine the impact of progressively increasing continuous positive airway pressure (CPAP) on measurements of the caval index (CI) using bedside ultrasound at the 3 common inferior vena cava (IVC) evaluation sites. METHODS: This was a prospective, observational trial that included 165 healthy adults over 18 years old enrolled between February 2015 and May 2018. Measurements of the IVC were obtained during normal tidal respirations from the subxiphoid area in the long and short axis and from the right mid‐axillary line in the long axis. Measurements were obtained in each of these locations at atmospheric pressure and with CPAP at 5, 10, and 15 cmH2O. The CI was then calculated for each of the 3 selected locations at each level of pressure. RESULTS: As CPAP pressures increased from 0 to 15 cmH2O the CI measurements obtained at the lateral mid‐axillary line did not show any statistically significant variation. There was a statistically significant difference (P < 0.001) when comparing measurements of the CI from the lateral mid‐axillary line location to both anterior locations. As CPAP pressures increased, the CI calculated from the subxiphoid area in both the anterior short and anterior long axis orientations initially trended upwards at 5 cmH2O, then began to downtrend as the pressures increased to 10 and 15 cmH2O. Comparing the CI measurements from the anterior long and anterior short axis at 0, 5, 10, and 15 cmH2O, there was no statistically significant difference at any pressure (P > 0.05). CONCLUSION: When evaluating the IVC in a spontaneously breathing patient, measurements from an anterior orientation are preferred as the lateral mid‐axillary view can underestimate CI calculations. |
format | Online Article Text |
id | pubmed-9716031 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97160312022-12-05 The effect of continuous positive airway pressure on inferior vena cava collapsibility as measured by bedside ultrasound Solis‐McCarthy, Jessica Gelabert, Christopher Michalek, Joel Sisson, Craig J Am Coll Emerg Physicians Open Imaging OBJECTIVES: The purpose of this study was to determine the impact of progressively increasing continuous positive airway pressure (CPAP) on measurements of the caval index (CI) using bedside ultrasound at the 3 common inferior vena cava (IVC) evaluation sites. METHODS: This was a prospective, observational trial that included 165 healthy adults over 18 years old enrolled between February 2015 and May 2018. Measurements of the IVC were obtained during normal tidal respirations from the subxiphoid area in the long and short axis and from the right mid‐axillary line in the long axis. Measurements were obtained in each of these locations at atmospheric pressure and with CPAP at 5, 10, and 15 cmH2O. The CI was then calculated for each of the 3 selected locations at each level of pressure. RESULTS: As CPAP pressures increased from 0 to 15 cmH2O the CI measurements obtained at the lateral mid‐axillary line did not show any statistically significant variation. There was a statistically significant difference (P < 0.001) when comparing measurements of the CI from the lateral mid‐axillary line location to both anterior locations. As CPAP pressures increased, the CI calculated from the subxiphoid area in both the anterior short and anterior long axis orientations initially trended upwards at 5 cmH2O, then began to downtrend as the pressures increased to 10 and 15 cmH2O. Comparing the CI measurements from the anterior long and anterior short axis at 0, 5, 10, and 15 cmH2O, there was no statistically significant difference at any pressure (P > 0.05). CONCLUSION: When evaluating the IVC in a spontaneously breathing patient, measurements from an anterior orientation are preferred as the lateral mid‐axillary view can underestimate CI calculations. John Wiley and Sons Inc. 2022-12-01 /pmc/articles/PMC9716031/ /pubmed/36474708 http://dx.doi.org/10.1002/emp2.12856 Text en © 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Imaging Solis‐McCarthy, Jessica Gelabert, Christopher Michalek, Joel Sisson, Craig The effect of continuous positive airway pressure on inferior vena cava collapsibility as measured by bedside ultrasound |
title | The effect of continuous positive airway pressure on inferior vena cava collapsibility as measured by bedside ultrasound |
title_full | The effect of continuous positive airway pressure on inferior vena cava collapsibility as measured by bedside ultrasound |
title_fullStr | The effect of continuous positive airway pressure on inferior vena cava collapsibility as measured by bedside ultrasound |
title_full_unstemmed | The effect of continuous positive airway pressure on inferior vena cava collapsibility as measured by bedside ultrasound |
title_short | The effect of continuous positive airway pressure on inferior vena cava collapsibility as measured by bedside ultrasound |
title_sort | effect of continuous positive airway pressure on inferior vena cava collapsibility as measured by bedside ultrasound |
topic | Imaging |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716031/ https://www.ncbi.nlm.nih.gov/pubmed/36474708 http://dx.doi.org/10.1002/emp2.12856 |
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