What is it about?
Understanding hemodynamic status of the patient with heart failure is the first step of the treatment. Hemodynamics is the relation between intravenous fluid volume and heart function. When physician assesses hemodynamics, the evaluation of right atrial pressure (RAP) is essential because it reflects intravenous volumes. In current practice, right atrial pressure is estimated from inferior vena cava (IVC) diameter and its respiro-phasic variations. However, the estimation equitation of the current guidelines are based on the small study and is not validated.
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Why is it important?
Our study used the largest number of patients that has ever reported, to examine the validity of the guideline. Our study showed that non-invasive estimation of elevated RAP using the existing guideline is inaccurate. Further, we proposed newer methods to estimate the right atrial pressure using the non-invasive IVC measurement. This study will be the basis for the intravenous volume assessment of the acutely ill patients.
Perspectives
The number of the study population is more than three times larger than the previous studies cited in the guideline. Hence, this study may be the basis of future discussion regarding the non-invasive estimation of RAP.
Dr Tetz Cheng-Che Lee
Columbia University
Read the Original
This page is a summary of: Estimation of Right Atrial Pressure on Inferior Vena Cava Ultrasound in Asian Patients, Circulation Journal, January 2014, Japanese Circulation Society,
DOI: 10.1253/circj.cj-13-1234.
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