Tchernodrinski Stefan, Lucas Brian P, Athavale Ambarish, Candotti Carolina, Margeta Bosko, Katz Ariel, Kumapley Rudolf
Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, IL.
J Clin Ultrasound. 2015 Mar;43(3):187-93. doi: 10.1002/jcu.22173. Epub 2014 Jun 4.
Measurement of the inferior vena cava (IVC) diameters may improve decision-making for patients hospitalized with acute decompensated heart failure. Nevertheless, little is known about how the IVC is affected by loop diuretics. We sought to determine if bolus infusions of intravenous furosemide affect IVC diameters measured by hand-carried ultrasonography.
We conducted a prospective cohort study at a public teaching hospital from September 2009 through June 2010. Physician investigators performed IVC ultrasonography on a convenience sample of 70 hospitalized adults who were prescribed intravenous furosemide for the diagnosis of acute decompensated heart failure.
Participants' median baseline IVC diameter was 2.38 cm (interquartile range, 1.91-2.55 cm). At 1-2 hours after furosemide, IVC diameters decreased an average of 0.21 cm (95% CI, 0.13-0.29 cm) and remained significantly below baseline at 2-3 hours after furosemide by an average of 0.15 cm (95% CI, 0.07-0.22 cm).
IVC diameters of adults diagnosed with acute decompensated heart failure become measurably smaller after single doses of intravenous furosemide. Whether this represents a true change in volume status has not been studied.
测量下腔静脉（IVC）直径可能有助于改善急性失代偿性心力衰竭住院患者的决策制定。然而，关于IVC如何受襻利尿剂影响的了解甚少。我们试图确定静脉推注呋塞米是否会影响手持式超声测量的IVC直径。
我们于2009年9月至2010年6月在一家公立教学医院进行了一项前瞻性队列研究。医师研究人员对70名因诊断为急性失代偿性心力衰竭而接受静脉注射呋塞米治疗的住院成年患者的便利样本进行了IVC超声检查。
参与者的IVC基线直径中位数为2.38 cm（四分位间距，1.91 - 2.55 cm）。在使用呋塞米后1 - 2小时，IVC直径平均减小0.21 cm（95%置信区间，0.13 - 0.29 cm），并且在使用呋塞米后2 - 3小时仍显著低于基线水平，平均低0.15 cm（95%置信区间，0.07 - 0.22 cm）。
诊断为急性失代偿性心力衰竭的成年人单次静脉注射呋塞米后，IVC直径明显变小。这是否代表容量状态的真正变化尚未得到研究。
