Thursday, October 22, 2015


You are passing by the critical care unit when you see the intensivist performing an ultrasound at the bedside of a patient. The ultrasound appears to be positioned in the midline, upper abdomen. The patient is an older patient with congestive heart failure who presented with septic shock from urinary tract infection.

Challenge: What is the intensivist doing?

Image shown under Fair Use.


Anonymous said...

IVC sniff test for hydration

Craig Chen said...

yep - volume status assessment

This is a subcostal view examining the inferior vena cava; the IVC can be seen passing through the liver and merging with the right atrium. The setting is Mmode which allows capture of the IVC diameter through the respiratory cycle. Looking at respiratory variation may predict response to volume challenge, particularly if the patient is mechanically ventilated.