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IVC image acquisition #IMPOCUS #MedTweetorial.

These 2 IVC M-mode images were obtained from the same patient 10 seconds apart. How could they be so different?

1/
60 m with hx of COPD, HFpEF, admitted w LLL PNA s/p abx and 1 L LR. HR 118 BP 110/70. IVC US was performed as a piece of info in determining whether to administer more IVF.

Measurement 1: 2.35-->0.92 (65% collapse)
Measurement 2: 2.22-->2.09 (5% collapse)

Why so different?

2/
First of all, how do you look at the IVC?
A common method is subxyphoid long axis, B mode or M mode. See below
-photo from emedicine.medscape.com/article/104401…
-excerpt from WikiM (wikem.org/wiki/IVC_ultra…) for a nice description
-an annotated sample B mode image and M mode image

3/
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