Proper fluid management while avoiding fluid overload can be one of the most difficult parts of practicing medicine. Unfortunately, many physicians using ultrasound mainly rely on Inferior Vena Cava (IVC) measurements to predict the “Fluid Status” (either deficient or overloaded) of their patients.

If you are guilty of this, don’t worry, the majority of people are. It’s probably because you just didn’t have a better way to help assess the fluid status of your patients other than IVC measurements.

However, solely using IVC measurement has many problems. IVC measurements are inaccurate because, just like central venous pressure (CVP), they do not accurately represent your patient’s preload in the left ventricle.

The IVC can also be dilated in conditions such as valvulopathies, pulmonary hypertension, or in patients with no comorbidities (such as athletes). Therefore a dilated IVC does not necessarily mean your patient is “fluid overloaded.”

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