[Relations of the ultrasonic image of the inferior vena cava and central venous pressure].

Abstract

In a prospective study of 50 patients a good correlation was found between the central venous pressure and the sonographic appearance of the inferior caval vein (ICV) behind the liver in right paramedian scanning. Dependent on central venous pressure (CVP) there were typical variations in the configuration, width and respiratory movements. These changes allowed a reliable estimation of the CVP. Decrease of the width in anteroposterior diameter in connection with a reduction of respiration-dependent caval movement indicated a deficiency of circulating blood volume. These alterations were always positive in cases of dehydration. Elongation of the vessel together with a widening over 2 cm and the lack of the normal end-inspiratory collapse were signs of an increased CVP. This non-invasive method is without risks or inconvenience for the patient. It is easily and quickly applied and very reliable for analyzing ICV haemodynamics. ICV ultrasonography can be recommended as a diagnostic aid for dehydration and hyperhydration as well as right heart failure, especially unrecognized, that means cardiac insufficiency without peripheral edema, constrictive pericarditis, tricuspid valve disease and for the assessment of the course of right cardiac failure.