VIDEO CME


https://doi.org/10.5005/jp-journals-10089-0034
Journal of Acute Care
Volume 1 | Issue 2 | Year 2022

Femoral Venous Doppler: A Marker of Venous Congestion


Vimal Bhardwajhttps://orcid.org/0000-0003-4273-2771

Consultant Intensivist, Narayana Health City, Bengaluru, Karnataka, India

Corresponding Author: Vimal Bhardwaj, Bengaluru, Karnataka, India, Phone: +91 9686124830, e-mail: vmlbhardwaj@yahoo.co.in

Received on: 12 November 2022; Accepted on: 19 November 2022; Published on: 31 December 2022

ABSTRACT

This video depicts the femoral venous Doppler (FVD) and inferior vena cava (IVC) relationship. IVC visualization has emerged as a popular technique to depict venous congestion and decide on deresuscitation/fluid administration. There are several scenarios wherein IVC visualization might be challenging for that is. Obesity, postabdominal, and cardiac surgeries, in addition to IVC visualization, are marred with imaging controversies surrounding the long and short axes with diaphragmatic movement causing false values of measurement.1 Considering the caveats surrounding IVC measurement and taking into consideration the anatomical, physiological continuum relationship between the right femoral vein and IVC. FVD might provide a reliable window into the dimension of IVC. Normal FVD is predominantly antegrade flow, nonpulsatile in nature, with a respiratory variation.2 The same has been shown in the video wherein IVC is <2 cm with respiratory variation, corresponding FVD shows predominant antegrade flow, nonpulsatile in nature, and abolishing waveform during inspiration which depicts a noncongested state.

How to cite this article: Bhardwaj V. Femoral Venous Doppler: A Marker of Venous Congestion. J Acute Care 2022;1(2):102-103.

Source of support: Nil

Conflict of interest: Dr Vimal Bhardwaj is associated as the Associate Editor of this journal and this manuscript was subjected to this journal’s standard review procedures, with this peer review handled independently of the Editor-in-Chief and his/her research group.

Keywords: Femoral venous Doppler, Inferior vena cava, Venous congestion.

This video depicts FVD and IVC relationship. IVC visualization has emerged as a popular technique to depict venous congestion and decide on deresuscitation/fluid administration. There are several scenarios wherein IVC visualization might be challenging for that is. Obesity, postabdominal, and cardiac surgeries, in addition to IVC visualization, are marred with imaging controversies surrounding the long and short axes with diaphragmatic movement causing false values of measurement.1

Considering the caveats surrounding IVC measurement and taking into consideration the anatomical, physiological continuum relationship between the right femoral vein and IVC. FVD might provide a reliable window into the dimension of IVC. Normal FVD is predominantly antegrade flow, nonpulsatile in nature, with a respiratory variation.2 The same has been shown in the video wherein IVC is <2 cm with respiratory variation, corresponding FVD shows predominant antegrade flow, nonpulsatile in nature, and abolishing waveform during inspiration which depicts a noncongested state (Figs 1 and 2).

Fig. 1: Shows IVC >2 cm with minimal respiratory variation

Fig. 2: Corresponding FVD shows predominant retrograde flow, pulsatile in nature without respiratory variation, which is clearly indicative of a severe congested state

Femoral venous Doppler can be a valuable tool in ascertaining a congested state when IVC visualization is challenging.

VIDEO

The above mentioned is available online on the website of www.jacutecare.com

ORCID

Vimal Bhardwaj https://orcid.org/0000-0003-4273-2771

REFERENCES

1. Finnerty NM, Panchal AR, Boulger C, et al. Inferior vena cava measurement with ultrasound: what is the best view and best mode? West J Emerg Med 2017;18(3):496–501. DOI: 10.5811/westjem.2016.12.32489

2. Denault AY, Aldred MP, Hammoud A, et al. Doppler interrogation of the femoral vein in the critically ill patient: the fastest potential acoustic window to diagnose right ventricular dysfunction? Crit Care Explor 2020;2(10):e0209. DOI: 10.1097/CCE.0000000000000209

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