Alborz University

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Introduction: Clinical ultrasonography may be provides a quick and non-invasive Modality for evaluation of patients’ hemodynamics for volume status. In this study we want to assess and attempt to analyze accuracy of inferior vena cava (IVC) ultrasonography and central venous catheterization in determine central venous pressure (CVP). Method and Materials: The patients were undergoing central venous catheterization, have been kept in an observational, diagnostic and comparative study. IVC diameters were determined by 2- dimensional bedside ultrasonography during 1 respiratory cycle and the caval index was measured. The correlation of CVP and caval index was measured. In addition, the sensitivity, specificity, positive and negative predictive values of caval index was calculated. Results: All 114 patients were divided in three groups: 59% of patients had CVP<8, 19% had 8 ≥ CVP≤12 and 22% had CVP>12. The relationship between caval index and CVP was 0.75. The results of this study demonstrated that the caval index≥ 50% can predict the CVP<8 with 91%sensitivity, 94% specificity, 94%positive predictive value, and 89.5% negative predictive value. Also, the caval index ≤28% can predict a CVP>12 with 96% sensitivity, 94.5%specificity, 83% positive predictive value and 98.8% negative predictive value. Discussion: Our results in this study told us that there is significant correlation between caval index≥50% and CVP<8 or caval index 28% and CVP>12. Conclusion: Ultrasound assessment of IVC dimensions may provide a quick and non-invasive hemodynamic monitoring method of assessing volume status and can performed by educated technician or medical students.

Keywords: Central Venous Pressure, hemodynamics, inferior vena cava, ultrasonography

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