Vena Cava Hemorrhage

Principal Investigator: Raminder Nirula
Keywords: radiology , trauma Department: General Surgery Faculty
IRB Number: 00090151 Co Investigator:  
Specialty: Trauma Surgery
Sub Specialties:
Recruitment Status: Recruiting

Contact Information

Katie Birkas

Brief Summary

The hypothesis of the proposed study is that an ultrasonic assessment (USA) protocol of inferior vena cava (IVC) diameter and collapsibility can detect and aid management of non-compressible hemorrhage in major trauma victims.

Specific aims of the study include:

  1. determine the sensitivity, specificity and accuracy of ultrasonic assessment (USA) of IVC diameters in detecting traumatic shock at admission as compared to vital signs,

  2. correlate the restoration of IVC diameters and collapsibility to achievement of endpoints of shock resuscitation in the ICU, such as correction of Base Deficit or lactate, evidence of improved organ perfusion such as urine output and avoidance of multiple organ dysfunction or death.

Inclusion Criteria

Inclusion criteria for subjects enrolled in the first year of this study will be:

      1. Major trauma patients brought to Level I Trauma Centers.

      2. Selected patients for the study will be those presenting with IVC collapsibility > 50% on   

          modified-FAST at admission and/or

      3. IVC diameter of < 12mm on modified FAST at admission and/or

      4. A non-visualized IVC due to total collapse on modified FAST at admission (not due to

          body habitus or inadequate ultrasonography technique)

Exclusion Criteria

     1. Pregnancy after 20 weeks gestation

     2. Those under 18 years of age

     3. Prisoners and others prohibited from participating in clinical trials

     4. Patients with severe traumatic brain injury who at admission are deemed by treating

         surgeons as having non-survivable brain injuries.

5. Body habitus (too obese to see IVC).