The ultrasonographic evaluation of vena cava inferior diameter as an intraabdominal pressure indicator

Abstract

Aim: Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are accepted as a significant cause of morbidity and mortality. The aim of this study is to investigate the utility of ultrasonography (US) as a non-invasive technique for evaluation of IAH, ACS and abdominal perfusion pressure (APP). Material and Methods: Ninety-five patients with intensive care unit requirement, who applied to emergency department and also received a urine catheter were included in the study. During first evaluation intraabdominal pressure (IAP) calculated via measuring intravesical pressure. Inferior vena cava (VCI) diameter, pulsed wave (PW) and central venous pressure (CVP) were recorded by using US. Patients were divided into three groups according to their IAP (IAP <12 mm Hg, IAP =12-20 mm Hg, IAP >20 mm Hg). Each group were evaluated separately in terms of VCI inspirium (i) and expirium (e) diameters. Results: Mean age of the patients was 68.6±14.5 (range, 24-91) years. Median IAP was 9.55 mm Hg and mean APP was 70.41±17.67 mm Hg. VCIi and VCIe diameters were significantly different in Group 1 with normal (<12 mm Hg) IAP (p<0.001). Correlation between VCI diameter and CVP among all patients were significant (p<0.001). Conclusion: A significant correlation between both VCIi and VCIe diameters, and CVP values in case of IAH presence was found in this study. We think that, recognition of IAP with non-invasive methods via evaluating high values of VCI diameter and CVP is effective for reducing morbidity and mortality providing early diagnosis and treatment.