Role of ultrasound in diagnosing volume status in critically ill patients

D.O. Starostin1, A.N. Kuzovlev2

1 Branch No. 8 (pgt. Selyatino) «1586 VKG» of the Ministry of Defense of Russia Moscow region

2 V.A. Negovsky research institute of general reanimatology of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow

Correspondence to: Artem N. Kuzovlev, MD, PhD, DrSci, head of the laboratory of clinical pathophysiology of critical states of the V.A. Negovsky research institute of general reanimatology Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow; e-mail:

For citation: Starostin D.O., Kuzovlev A.N. Role of ultrasound in diagnosing volume status in critically ill patients. Alexander Saltanov Intensive Care Herald. 2018;4:42–50.

DOI: 10.21320/1818-474X-2018-4-42-50

Currently, various methods are available for assessing volemic status and volume responsiveness in critically ill patients. A significant advantage of ultrasound methods is their non-invasiveness, ease of use, and a quick learning curve, which makes them probably the most promising in the clinical practice. This literature review outlines the basic principles of diagnosis and evaluation of the volemic status of critically ill patients. The informativity of central venous pressure, hemodynamic tests (volume loading teats, passive leg raising test), as well as instrumental methods for assessing volemic status, in particular ultrasound (assessment of respiratory modulation of the inferior vena cava, collapse of internal jugular vein, transthoracic and transesophageal echocardiography).

Keywords: volemic status, hypovolemia, ultrasound, passive leg raising test, cardiac output

Received: 08.10.2018


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Volumetric Compressive Oscillometry for Cardiac Output Evaluation

V.A. Mazurok

Almazov North-West Federal Medical Research Centre, Saint-Petersburg

For correspondence: Vadim A. Mazurok — D. Sci. Med., professor, head of Department of anesthesiology and reanimatology, Almazov North-West Federal Medical Research Centre, Saint-Petersburg; е-mail:

For citation: Mazurok VA. Volumetric Compressive Oscillometry for Cardiac Output Evaluation. Intensive Care Herald. 2017;2:55–60.

The study discusses different techniques proposed for cardiac output assessment. One of them is a non-invasive volumetric compressive oscillometry (VCO). VCO bases on measurements of the blood volume change under an inflatable cuff around an extremity. VCO determines blood pressure by recording the volumetric arterial oscillograms allowing speed and character of pulse-wave increase and decrease evaluation, and judgment about heart pump condition and vascular walls elasticity. Objective. To compare the heart pump capacity determined by two different techniques: classical pre-pulmonary thermodilution and VCO. Materials and methods. Seven intensive care unit patients in early postoperative periods after open-heart surgery were included. Two hundreds parallel measurements of cardiac output (CO) performed during several days. One hundred by the pre-pulmonary thermodilution techniques with catheter Swan-Ganz in pulmonary artery (CareScape monitor B850, GE Healthcare), and one hundred by the VCO (Multimodal monitor 6-03, Triton, Russia). The data showed as CO and cardiac index (CI) — CO divided by the body surface area. For statistical analysis calculated mean error, received data displayed by Bland—Altman plot. Results. CO and CI figures were found to be comparable: 5.41 ± 0.12 & 5.33 ± 0.13 l∙min–1, and 2.93 ± 0.13 & 2.92 ± 0.94 l∙min–1∙м–2, correspondingly. Mean error for CO and CI was about 10 %. VCO overvaluation of CO and CI relatively to thermodilution was 11.1 ± 1.2 & 9.6 ± 1.1 %; undervaluation — 10.8 ± 1.3 & 12.1 ± 1.3 %, correspondingly. Conclusion. Volumetric compressive oscillometry can be safely used for CO measurement in cardio-surgical patients. Researcher should keep in mind limitations of any technique based on the pulse-way analysis.

Keywords: volumetric compressive oscillometry, cardiac output

Received: 01.04.2017


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