Role of inferior vena cava diameter in assessment of volume status: A meta-analysis

Agarwal Dipti, Zachary Soucy, Alok Surana, Subhash Chandra

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Background and Objective: Hypovolemic shock is an important cause of death in the emergency department (ED). We sought to conduct a meta-analysis to quantify existing evidence on sonographic measurement of inferior vena cava (IVC) diameter in assessing of volume status adult ED patients. Methods: A search of 5 major databases of biomedical publication, EMBASE, Ovid Medline, evidence-based medicine (EBM) Reviews, Scopus, and Web of Knowledge, was performed in first week of March 2011. Studies meeting the following criteria were included: (1) prospectively conducted, (2) measured IVC diameter using ultrasonography, (3) inpatients under spontaneous ventilation, and (4) reported IVC diameter measurement with volume status or shock. Article search, study quality assessment, and data extraction were done independently and in duplicate. Mean difference in IVC diameter was calculated using RevMan version 5.5 (Cochrane collaboration). Results: A total of 5 studies qualified for study eligibility from 4 different countries, 3 being case-control and 2 before-and-after design, studying 86 cases and 189 controls. Maximal IVC diameter was significantly lower in hypovolemic status compared with euvolemic status; mean difference (95% confidence interval) was 6.3 mm (6.0-6.5 mm). None of the studies blinded interpreters for volume status of participants. Conclusion: Moderate level of evidence suggests that the IVC diameter is consistently low in hypovolemic status when compared with euvolemic. Further blinded studies are needed before it could be used in the ED with confidence.

Original languageEnglish (US)
JournalAmerican Journal of Emergency Medicine
Volume30
Issue number8
DOIs
StatePublished - Oct 2012
Externally publishedYes

Fingerprint

Inferior Vena Cava
Meta-Analysis
Hospital Emergency Service
Hypovolemia
Shock
Evidence-Based Medicine
Ventilation
Publications
Inpatients
Cause of Death
Ultrasonography
Databases
Confidence Intervals

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Role of inferior vena cava diameter in assessment of volume status : A meta-analysis. / Dipti, Agarwal; Soucy, Zachary; Surana, Alok; Chandra, Subhash.

In: American Journal of Emergency Medicine, Vol. 30, No. 8, 10.2012.

Research output: Contribution to journalArticle

Dipti, Agarwal ; Soucy, Zachary ; Surana, Alok ; Chandra, Subhash. / Role of inferior vena cava diameter in assessment of volume status : A meta-analysis. In: American Journal of Emergency Medicine. 2012 ; Vol. 30, No. 8.
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