[Measurement of anterior-posterior diameter of IVC by ultrasonography: a non invasive method for estimation of central venous pressure]

The assessment of intravascular volume in severely traumatized patients or patients admitted in ICU is very essential. At present the accurate method for estimating the intravascular volume requirement is by measuring the CVP which is an invasive method. The measurement of IVC diameter by ultrasound has been suggested as an easily available and simple method for measuring the intravascular volume status. The purpose of this study was to compare the results of IVC diameter measurement by ultrasonography and CVP measurement for calculating the intravascular volume in ICU admitted patients. This was a descriptive and prospective stud]' including 50 patients admitted in ICU with a central Venous catheter placed for any reason whatsoever and no signs of increased right atrial pressure. CVP was measured in supine position by CVP manometer. The anterior- posterior IVC diameter was assessed by ultrasonography during inspiration and expiration. Data analysis was performed by SPSS and evaluated statistically with Pearsons regression and linear correlation test. The mean CVP at inspiration and during expiration was 11.35 +/- 5.53, 12.20 +/- 5.65 cm H2O, respectively. The mean of inspiratory and expiratory IVC diameter was 7.71 +/- 3.5, 11.37 +/- 3.28 mm, respectively. There was significant correlation between CVP and IVC diameter both during inspiration [r= 0.64, p-value= 0.001] and expiration [r=0.495, p-value=0.001] The result of this study suggests that IVC diameter measurement by ultrasound can be used as a reliable and non- invasive method for estimating the intravascular volume

[Carotid artery sonography findings in 291 patients undergoing CABG]

Doppler ultrasonography [DUS] is the most preferable method for screening of carotid artery disease in patients undergoing CABG. The purpose of this study was to investigate the frequency of carotid artery disease and determine the relation between known risk factors of atherosclerosis and rate of carotid artery narrowing in order to identify high-risk groups among patients scheduled for isolated elective coronary artery bypass grafting [CABG] procedures. Two-hundred ninety-one patients [222 males and 69 females] undergoing isolated coronary artery bypass grafting were preoperatively evaluated by carotid artery Doppler ultrasomography and the morphology of carotid artery was determined. Age, sex, cervical bruit, diabetes mellitus [DM], hypertension, hyperlipidemia, smoking, history of cerebrovascular event [CVE] and coronary angiographic findings were investigated to define the high-risk group for carotid artery disease. Data were analyzed by SPSS software and P<0.05 was considered significant. Patients ages ranged from 35 to 95 years [mean of 57.6 +/- 10.4 years]. Eleven patients [3.8%] had history of cerebrovascular events [CVE]. 13 patients [4.5%] had cervical bruit. Left main coronary artery involvement was observed in 19 patients [6.4%]. In 127 patients [43.6%] carotid scanning was normal, fifty nine patients [20.4%] had less than 50% stenosis [mild stenosis], ninty seven patiens [33.3%] had 50-70% stenosis [moderate stenosis], and eight patiens [2.7%] had more than 75% stenosis [severe stenosis]. Calcified plaque was observed in 109 patients [37.5%]. Previous cerebral ischemic events [P=0.297], diabetes mellitus [P=0.467], hypertension [P=0.110], hyperlipidemia [P=0.08], smoking [P=0.401], age >60 years [P=0.84], female sex [P=0.730], and left main coronary disease [P=0.390] were not identified as high-risk factors for carotid artery stenosis greater than 50%. But positive MI history [P=0.025], and cervical bruit [P=0.002], were significantly related to 50% carotid artery stenosis. Based on the results of this study, we can not suggest DUS as a routine screening method in all patients undergoing CABG, except for patients with history of MI and cervical bruit. Another important finding was that 56.4% of patients posted for CABG had different degrees of carotid artery stenosis which requires a long term CVA prophylaxis program