So we are going to use the same plane of interrogation to look at the IVC as we do the aorta, this is just going to be slightly to the patients right and this is showing a sagittal view, where we’ve got the IVC draining into the right atrium of the heart.
Keep in mind that the IVC and the aorta are adjacent to each other and very small tilting motions of the probe can have you visualize one or the other and you need to be careful not to mix the two up. In this case, we see the IVC, the hepatic veins draining into it and into the right atrium. Just adjacent to that we also see the aorta traveling along he vertebral bodies and up behind the heart through the diaphragm.
So when we visualize it correctly, we will see the IVC draining into the heart. In this case, the patient is giving a little bit of a sniff, which is collapsing the IVC. This is pretty normal hydration status.
Here’s an example of an IVC that is quite flat. In fact, it’s so flat it difficult to actually see it, but we can see it right in the liver there, draining into the right atrium. This is a patient that is going to be dehydrated, they could benefit from some fluids in most cases and IVC can help you with your hydration status.
This IVC is a bit easier to see. This patient is fluid overloaded; they have a dilated and non collapsible IVC, and they are less likely to benefit from hydration.They probably have some degree of congestive heart failure or fluid overload.
Again we can use inspiration or a sniff by the patient to look at collapsibility of the IVC in a euvolemic or normovolemic patient. There is going to be some collapse of the IVC with inspiration and negative pressure in the chest. The IVC drains in and then collapses some.