title: Inferior vena cava diameter change after intravenous furosemide in patients diagnosed with acute decompensated heart failure.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, IL.
authors.forename: Stefan
authors.initials: S
authors.lastname: Tchernodrinski
authors.forename: Brian P
authors.initials: BP
authors.lastname: Lucas
authors.forename: Ambarish
authors.initials: A
authors.lastname: Athavale
authors.forename: Carolina
authors.initials: C
authors.lastname: Candotti
authors.forename: Bosko
authors.initials: B
authors.lastname: Margeta
authors.forename: Ariel
authors.initials: A
authors.lastname: Katz
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kumapley
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005665:Furosemide / Q000008:administration & dosage / Q000627:therapeutic use*; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging* / Q000187:drug effects*; D055815:Young Adult
chemical_list: D004232:Diuretics; D005665:Furosemide
keywords: echocardiography; furosemide; inferior vena cava; mixed-effects regression models; point-of-care systems