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The Interrater Reliability of Ultrasound Imaging of The Inferior Vena Cava Performed By Emergency Residents

Posted in: Emergency Medicine, Inferior Vena Cava|July 25, 2014
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SONOSIM SUMMARY: This study assesses the interrater reliability of emergency medicine residents using ultrasound to measure inferior vena cava (IVC) diameter. Interrater reliability was notably higher when IVCs were positioned more anteriorly, and increased as residents performed more ultrasounds over the course of the study. Results suggest that emergency medicine residents are equipped to measure inferior vena cava diameter using bedside ultrasound with moderate reliability, which may progressively improve with ultrasound experience.
 
Akkaya A, Yesilaras M, Aksay E, et. al. The interrater reliability of ultrasound imaging of the inferior vena cava performed by emergency residents. Am J Emerg Med. 2013 Sept;3(10): 1509 – 1511.

Abstract

Objectives

Ultrasonography (US) has gained popularity in the emergency medicine to assess intravascular volume status in critically ill patients. However, there are a limited number of studies on the interrater reliability of US examination of the inferior vena cava (IVC) by emergency residents.

Methods

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One hundred eighty US examinations were performed on 90 emergency critical care unit patients by 6 emergency medicine residents. Minimum and maximum IVC diameters during normal passive inspiration were measured, and the IVC index was calculated. The interrater reliability of the measurable data was analyzed using intraclass correlation coefficients.

Results

The measurements of minimum and maximum IVC diameters were moderately reliable by emergency residents (κ = 0.60 [95% confidence interval {CI}, 0.45-0.72] and κ = 0.56 [95% CI, 0.41-0.69], respectively). In the patients with moderate IVC depth (8.5-12.5 cm), the interrater reliabilities of sonographers were κ = 0.51 (95% CI, 0.30-0.67) for maximum diameter and κ = 0.43 (95% CI, 0.21-0.61) for minimum diameter. In patients with superficial (≤8.5 cm) and profound located (≥12.5 cm) IVC, the interrater reliabilities of sonographers for maximum and minimum diameters were κ = 0.69 (95% CI, 0.29-0.89) and κ = 0.75 (95% CI, 0.4-0.91), and κ = 0.58 (95% CI, 0.09-0.85) and κ = 0.76 (95% CI, 0.39-0.92), respectively.

Conclusions

The measurement of the IVC is moderately reliable by emergency residents. The interrater reliability of measurements in patients with profound and superficial located IVC is higher than that of measurements in patients with moderate-depth located IVC.

To read the complete article, visit The American Journal Of Emergency Medicine website by clicking here.

SonoSim Keywords: Ultrasound, Vascular, IVC, Emergency Medicine

February 14, 2017 System Administrator

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