Doppler Interrogation of the Femoral Vein in the Critically Ill Patient: The Fastest Potential Acoustic Window to Diagnose Right Ventricular Dysfunction?
bedside ultrasound
common femoral vein
right ventricular dysfunction
venous congestion
Journal
Critical care explorations
ISSN: 2639-8028
Titre abrégé: Crit Care Explor
Pays: United States
ID NLM: 101746347
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
entrez:
16
10
2020
pubmed:
17
10
2020
medline:
17
10
2020
Statut:
epublish
Résumé
To report the use of common femoral vein Doppler interrogation as a simple technique to diagnose right ventricular dysfunction. Case report. Cardiac surgical ICU. Postoperative cardiac surgical patients. Common femoral pulsed-wave and color Doppler examination associated with hepatic, portal, and renal venous Doppler measurement were obtained in both patients and before and after treatment in patient number 1. In addition, right ventricular pressure waveform examination was obtained in patient number 2. The technique to obtain common femoral venous Doppler is described. Two cases of patients presenting with right ventricular dysfunction and fluid overload with portal and renal venous congestion in the perioperative period undergoing complex multivalvular cardiac surgery are presented. Hemodynamic waveform monitoring was performed alongside echocardiographic, hepatic, and renal venous flow Doppler assessment, and spectral Doppler profiles of the common femoral veins were examined. Those findings were useful in confirming our diagnosis and guiding our response to treatment. An algorithm was developed and tested on two additional hemodynamically unstable patients. Doppler examination of the common femoral vein is a simple, fast, and noninvasive technique that could be useful to rule in the presence of right ventricular dysfunction with venous congestion and help guide the management of such patients.
Identifiants
pubmed: 33063023
doi: 10.1097/CCE.0000000000000209
pmc: PMC7523763
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e0209Informations de copyright
Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.
Déclaration de conflit d'intérêts
Dr. Denault is on the Speakers’ Bureau for CAE Healthcare (2010), Masimo (2017), Edwards (2019) and received an equipment grant from Edwards (2019). The remaining authors have disclosed that they do not have any potential conflicts of interest.
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