Technique for measuring the IVC:
With the probe marker pointed at the patient's feet, gently press below the xiphoid process and angle the transducer beam towards the patient's left side (into the liver). You should then see the IVC in long axis below the liver, returning blood to the right ventricle.
Measurement of the of the IVC (inside diameter) is taken in its widest dimension 2cm distal to the IVC/hepatic vein junction; the measurement here and percent collapse during normal respiration may be correlated to RA pressure in the table on the previous page.
Limitations in measurement certainly would include right sided heart disease and tricuspid insufficiency/stenosis.
Cartoon of image:
Actual image depicting cartoon:
Enjoy measuring some IVCs, and grab me if you need any help.
Thanks for looking!
References:
1. Title pending, Clin J Am Soc Nephrol 1: 749-753, 2006.
2. Title pending, Am J Cardiol. 1990 Aug 15;66(4):493-6.
3. Title pending, J Am Soc Echocardiogr. 1992 Nov-Dec;5(6):613-9.
4. Sonographic measurement of the inferior vena cava as a marker of blood loss. Lyon M; Blaivas M; Brannam L. Am J Emerg Med 2005 Jan; Vol. 23 (1), pp. 45-50.
5. Early diagnosis of hypovolemic shock by sonographic measurement of inferior vena cava in trauma patients. Yanagawa Y, The Journal Of Trauma, 2005 Apr; Vol. 58 (4), pp. 825-9.
6. Ma, Mateer. Emergency Ultrasound, 2003.
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