• Robert B Holtzman, Lawrence Lottenberg, Thomas Bass, Angeleke Saridakis, Vicki J Bennett, and Eddy H Carrillo.
• Division of Trauma and Critical Care, Memorial Regional Hospital, 3501 Johnson St., Hollywood, FL 33021, USA.
• Am. J. Surg. 2003 Apr 1;185(4):364-8.

BackgroundThe use of iodinated contrast in the critically ill trauma patient has been associated with the development of acute renal failure. The low incidence of nephrotoxicity associated with carbon dioxide (CO(2)) makes it an ideal contrast agent for cavography. However, the use of CO(2) has been limited, because reportedly it underestimates the diameter of the inferior vena cava (IVC).MethodsDuring a 6-month period (January 2000 through June 2000), 25 adult trauma patients required IVC filter placement. Bedside cavagrams using CO(2) followed by iodinated contrast were employed to determine the diameter of the IVC and the anatomy of the renal veins.ResultsUsing CO(2) injection for cavography, we were able to determine the diameter of the IVC and the anatomy of the renal veins in all patients. Furthermore, when CO(2) cavography was compared with the results obtained with iodinated contrast, the difference in diameter of the IVC was within 1 mm.ConclusionsBased on these data, it was determined that CO(2) cavagrams accurately reflect the diameter of the IVC and the anatomy of the renal veins. Additionally, CO(2) cavagrams can be safely performed in the intensive care unit during bedside placement of IVC filters.

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