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A small inferior vena cava (IVC) diameter has been shown to reflect hemorrhagic shock. These authors prospectively assessed IVC diameter immediately after fluid resuscitation in trauma patients who had shock on arrival to the emergency department. Using sagittal ultrasound views, the researchers measured the maximum anterior–posterior IVC diameter just below the diaphragm in the hepatic segment during the expiratory phase of breathing.
Of 488 blunt trauma patients who were transferred to a single level I trauma center in Japan during 2004 to 2006, 73 had shock (defined as blood pressure <90 mm Hg plus clinical manifestations) on ED arrival. After exclusion of 36 patients who were admitted at night and 7 whose BP failed to respond to initial …