Caval Aortic Index: A Novel Tool for Fluid Assessment in Obstetric Emergencies.
Caval aortic index
fluid assessment
obstetric emergencies
ultrasound
Journal
Journal of emergencies, trauma, and shock
ISSN: 0974-2700
Titre abrégé: J Emerg Trauma Shock
Pays: India
ID NLM: 101493921
Informations de publication
Date de publication:
Historique:
received:
30
11
2018
accepted:
31
05
2019
entrez:
13
5
2020
pubmed:
13
5
2020
medline:
13
5
2020
Statut:
ppublish
Résumé
Uncorrected maternal hypotension occurring during obstetric emergencies may result in maternal and fetal morbidity. Fluid status of the pregnant mother is a major variable which affects the maternal hemodynamics during patient management, and there is no objective assessment tool for the same. A relatively new sonographic parameter, the inferior vena cava aorta (IVC/Ao) diameter index or caval aortic index, showed promise in this regard, and its application was studied in obstetric patients. A prospective analytical study was conducted involving 50 pregnant and 50 nonpregnant women of reproductive age group. Using both subxiphoid and transhepatic views, their normal fasting caval aortic indices were determined from the ratio of mean IVC diameter to the mean aortic diameter. Descriptive and inferential statistical analyses were carried out accordingly. Normal IVC/Ao diameter index for nonpregnant healthy women of reproductive age was 1.11 ± 0.29 in the subxiphoid view and 1.21 ± 0.33 in the transhepatic view. The difference between the two views was not statistically significant. IVC/Ao diameter index for a normal term pregnant woman was 1.03 ± 0.26, and term pregnancy does not significantly cause variation in the index. Caval aortic index is a useful noninvasive tool to assess volume status and guide fluid management in pregnant women presenting to the emergency department, and the transhepatic view is comparable to the traditional subxiphoid view for the measurement of the same.
Sections du résumé
BACKGROUND
BACKGROUND
Uncorrected maternal hypotension occurring during obstetric emergencies may result in maternal and fetal morbidity. Fluid status of the pregnant mother is a major variable which affects the maternal hemodynamics during patient management, and there is no objective assessment tool for the same. A relatively new sonographic parameter, the inferior vena cava aorta (IVC/Ao) diameter index or caval aortic index, showed promise in this regard, and its application was studied in obstetric patients.
METHODOLOGY
METHODS
A prospective analytical study was conducted involving 50 pregnant and 50 nonpregnant women of reproductive age group. Using both subxiphoid and transhepatic views, their normal fasting caval aortic indices were determined from the ratio of mean IVC diameter to the mean aortic diameter. Descriptive and inferential statistical analyses were carried out accordingly.
RESULTS
RESULTS
Normal IVC/Ao diameter index for nonpregnant healthy women of reproductive age was 1.11 ± 0.29 in the subxiphoid view and 1.21 ± 0.33 in the transhepatic view. The difference between the two views was not statistically significant. IVC/Ao diameter index for a normal term pregnant woman was 1.03 ± 0.26, and term pregnancy does not significantly cause variation in the index.
CONCLUSIONS
CONCLUSIONS
Caval aortic index is a useful noninvasive tool to assess volume status and guide fluid management in pregnant women presenting to the emergency department, and the transhepatic view is comparable to the traditional subxiphoid view for the measurement of the same.
Identifiants
pubmed: 32395050
doi: 10.4103/JETS.JETS_136_18
pii: JETS-13-50
pmc: PMC7204966
doi:
Types de publication
Journal Article
Langues
eng
Pagination
50-53Informations de copyright
Copyright: © 2020 Journal of Emergencies, Trauma, and Shock.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Semin Dial. 2004 Jan-Feb;17(1):37-43
pubmed: 14717810
J Trauma. 2007 Dec;63(6):1245-8; discussion 1248
pubmed: 18212645
J Ultrason. 2014 Sep;14(58):273-9
pubmed: 26675322
Nephrol Dial Transplant. 2001 Jun;16(6):1203-6
pubmed: 11390721
Clin J Am Soc Nephrol. 2006 Jul;1(4):749-53
pubmed: 17699282
Nephrol Dial Transplant. 1996 Aug;11(8):1564-7
pubmed: 8856212
Bratisl Lek Listy. 2008;109(4):185-7
pubmed: 18814438
Acad Emerg Med. 2007 Oct;14(10):841-5
pubmed: 17898246
Blood Purif. 2004;22(4):351-9
pubmed: 15297785
Anesthesiology. 1970 Jul;33(1):25-34
pubmed: 5464319
Am J Emerg Med. 2018 Sep;36(9):1529-1533
pubmed: 29310984