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• W2070546588 abstract "We read with great interest the article by Lorsomradee et al studying the inferior vena cava diameter (IVCD) and central venous pressure (CVP) correlation during cardiac surgery.1Lorsomradee Su Lorsomradee Sr Cromheecke S. et al.Inferior vena cava diameter and central venous pressure correlation during cardiac Surgery.J Cardiothorac Vasc Anesth. 2007; 21: 492-496Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar We applaud their efforts in trying to find yet another means to determine preload in the operating room. We ourselves have been trying to elucidate the same question for the past 2 years and, in fact, presented a very similar study in 50 patients in the form of an abstract at the American Society of Anesthesiologists annual meeting in 2005.2Arthur M. Landolfo C. Lewis N. et al.Measurement of the inferior vena cava diameter (IVCD) by transesophageal echocardiography (TEE) as a means of assessing the central venous pressure (CVP) during cardiac surgery.Anesthesiology. 2005; 103 (abstr): A357Google Scholar Lorsomradee and colleagues1Lorsomradee Su Lorsomradee Sr Cromheecke S. et al.Inferior vena cava diameter and central venous pressure correlation during cardiac Surgery.J Cardiothorac Vasc Anesth. 2007; 21: 492-496Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar reached the conclusion in their study that there is a strong correlation between the transesophageal echocardiography–derived IVCD and the CVP in cardiac surgical patients. According to this report, this correlation was only significant for CVP values less than 11 mmHg. In our study, this correlation was maintained over a much broader range of central venous pressures from 8 to 22 mmHg (r = 0.962, p < 0.001) and was maintained both prebypass (r = 0.944622, r2 = 0.89231, p < 0.000125) and postbypass (r = 0.884553, r2 = 0.782434, p < 0.001535) with no statistically significant differences between the two.3Castresana M. Arthur M. Lewis N. et al.Pre-and postbypass inferior vena cava (IVC) diameter and central venous pressure (CVP) correlation during cardiac surgery.Anesthesiology. 2005; 103 (abstr): A401Crossref PubMed Scopus (92) Google Scholar Given the differences between the two study conclusions, it will be interesting to know why Lorsomradee and colleagues did not assess right ventricular function in their patients, and what degree of tricuspid regurgitation was considered exclusive. What exactly did the authors mean by tricuspid valve disease? Was this structural or functional? Isn't the utility of CVP measurements greater in the patient group with elevated CVP and right-heart pathology? Mild tricuspid regurgitation is common in the general patient population and can be influenced by pacemaker wires and central venous and pulmonary artery catheters. All these factors are important, more so in chronic respiratory disease, smoking, and obesity, and may affect the measurement and significance of the results. Finally, one of the issues encountered after completing IVCD measurements at the inferior vena cava–right atrial junction in more than 300 patients is the lack of consistency in identifying the inferior vena cava–right atrial junction with a transesophageal echocardiography bicaval view in a small subset of patients and the possibility of mistakenly measuring the coronary sinus diameter instead of the inferior vena cava. To avoid this error, following the IVC into the liver to exclude the coronary sinus is of added importance. Inferior Vena Cava Diameter and Central Venous Pressure Correlation During Cardiac SurgeryJournal of Cardiothoracic and Vascular AnesthesiaVol. 21Issue 4PreviewObjective: The purpose of this study was to determine whether a relationship exists between the inferior vena cava diameter (IVCD) or the superior vena cava diameter (SVCD) measured at the point of entry into the right atrium using transesophageal echocardiography (TEE) and the central venous pressure (CVP) under different experimental conditions.Design: Prospective study.Setting: University hospital, single institution.Participants: Seventy patients undergoing elective cardiac surgery.Interventions: CVP, IVCD, and SVCD were measured in a 2-dimensional, long-axis midesophageal bicaval view at end-diastole with electrocardiographic synchronization. Full-Text PDF ReplyJournal of Cardiothoracic and Vascular AnesthesiaVol. 22Issue 6PreviewWe thank Drs Arthur and Castresana for their interest in our article.1 They raise an interesting issue, which is that the relation between the inferior vena cava diameter (IVCD) and the central venous pressure (CVP) may actually depend on the right ventricular function. The patients included in our study had preserved right and left ventricular function so we cannot comment on potential influences of the underlying right ventricular function. To assess the functional reserve capacity of the heart,2-4 we also performed a dynamic stress test of the heart by passive elevation of the legs. Full-Text PDF" @default.
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• W2070546588 title "Correlation of the Inferior Vena Cava Diameter With the Central Venous Pressure" @default.
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• W2070546588 doi "https://doi.org/10.1053/j.jvca.2007.09.024" @default.
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