Ultrasound Guided Volume Assessment Starr Knight, M.D. HIGH RISK - - PowerPoint PPT Presentation

Ultrasound Guided Volume Assessment

Starr Knight, M.D. HIGH RISK Hawaii Feb 14, 2014

Outline

• IVC Ultrasound Technique
• Clinical Use of IVC Ultrasound
• Clinical Cases

IVC Ultrasound Exam

• Exam Technique
• Goals of the Exam
• Pitfalls

Probe Selection

Liver

IVC

RA

RA

Liver

IVC

Hypovolemia Hypervolemia

Hypovolemia Hypervolemia

The “Sniff” Test

Hypovolemia Hypervolemia

Caval Index

Ultrasound Protocols

• RUSH
• RADiUS
• Triple Scan
• 1. Cardiac Ultrasound
• 2. Lung Ultrasound
• 3. IVC Ultrasound

Goals of the Exam

Assess for Pulmonary Edema Evaluate Pump Function Interrogate IVC

Protocol

• 1. Cardiac Ultrasound
• 2. Lung Ultrasound
• 3. IVC Ultrasound

Clinical Cases

Septic

Before IVFs After 2L IVFs

CHF

Pulmonary Embolism

Cardiac Tamponade

Take Home Points

• Distinguish IVC from Aorta
• Eval IVC 2cm distal to RA-IVC junction
• Use in conjunction with Cardiac and Lung ULS
• Remember Conditions with ↑R Cardiac Pressure
• Serial Exams during resuscitation

References

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References

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