• Jacobo Moreno Garijo, Duminda N Wijeysundera, Jo Carroll Munro, and Massimiliano Meineri.
• Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada.
• J. Cardiothorac. Vasc. Anesth. 2017 Jun 1; 31 (3): 973-979.

ObjectivesTo assess the feasibility and reliability of transthoracic echocardiography to measure inferior vena cava (IVC) diameter variation using a transhepatic view.DesignProspective cohort study.SettingSingle-center hospital.PatientsForty consecutive patients undergoing elective cardiac surgery.InterventionsBedside transthoracic echocardiography.Measurements And Main ResultsCorrelation between the two views was measured using Pearson R, while agreement was measured using the intraclass correlation coefficient (ICC). In a nested sub-study of 16 randomly selected participants, all images were re-rated by the same rater, who was blinded to the original measurement results, and by a second blinded operator. Correlation between the subcostal and transhepatic views was moderate when assessing maximum (R 0.46; 95% confidence interval [CI], 0.18-0.68), and minimum (R 0.55; CI, 0.29-0.74) IVC diameter. Correlation when measuring IVC diameter variation was higher (R 0.70; CI, 0.49-0.83). Agreement between the two views for IVC diameter variation measurement was substantial (ICC 0.73; CI, 0.49-0.85). Intra-rater reliability was excellent (ICC 0.95-0.99).ConclusionsAgreement between subcostal and transhepatic views was substantial for the assessment of IVC diameter variation; however, the magnitude of agreement was less than anticipated. Further research is needed to determine if the transhepatic view can be used reliably in the assessment of fluid responsiveness.Copyright © 2017 Elsevier Inc. All rights reserved.

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