Inferior Vena Cava

The ideal IVC view is longitudinal allowing visualization as it courses through the liver and enters into the right atrium.

Transducer placement (Figure 1)

  • Once the right ventricle and atrium are identified in the subxyphiod
  • Rotate the probe counterclockwise 90 degrees
  • Longitudinal images are best obtained for IVC measurements (Clip 1)
  • Look for the confluence of the hepatic vein into the IVC (Figure 2)
  • The IVC can be differentiated from the aorta by its thinner walls and collapse during respirations
  • May need to increase the depth

Orientation Cardiac Presets (Figure 2)

  • IVC longitudinal view, indicator is towards the patient’s head
  • Indicator on the right of the screen

Orientation Abdominal Presets for the FAST and RUSH (Figure 3)

  • IVC the indicator is towards the patient’s head
  • Indicator on the left of the screen

Tips

  • This view allows assessment for IVC diameter, and IVC diameter change with respiration
  • M-mode or 2D caliper can be used to make the measurements

Figures and Clips

Figure 1 - Transducer Placement

Figure 2 - Orientation

Figure 3 - Ideal IVC - Cardiac Preset

Figure 4 - Ideal IVC - Abdominal Preset

Clip 1 - IVC Respiratory Variation

References

Moore, Christopher L., and Joshua A. Copel. “Point-of-care ultrasonography.” New England Journal of Medicine 364.8 (2011): 749-757.