{"id":1794,"date":"2020-08-26T08:00:29","date_gmt":"2020-08-26T08:00:29","guid":{"rendered":"http:\/\/emultrasound.sdsc.edu\/?p=1794"},"modified":"2021-05-04T16:56:32","modified_gmt":"2021-05-04T16:56:32","slug":"ivc-collapsibility","status":"publish","type":"post","link":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/","title":{"rendered":"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients?"},"content":{"rendered":"
\n
\n
\n

Background<\/h2>\n

Fluid responsiveness is key in guiding the resuscitation of critically ill patients, and both under and over resuscitation can lead to poor clinical outcomes. Vitals and physical exam are not always reliable in determining fluid responsiveness. The search for a quick, easy and accurate diagnostic test to determine fluid responsiveness is ongoing. IVC collapsibility (cIVC) has been proposed as a helpful measure, and in ventilated patients this measurement has been validated. However, spontaneously breathing patients have different physiology, so it is unclear if cIVC is an accurate predictor of fluid responsiveness in this cohort. Previous studies have recommended a cIVC cutoff of 40-42% as a reliable predictor of fluid responsiveness in spontaneously breathing patients (1,2). This study sought to validate those findings. <\/p>\n

 <\/p>\n

Inferior vena cava collapsibility detects fluid responsiveness among spontaneously breathing critically-ill patients<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n

\n
\n
\n

Clinical Question<\/h3>
\n

Can the collapsibility of the inferior vena cava differentiate between fluid responders and fluid non-responders in non-ventilated critically ill patients?<\/span><\/p>\n<\/div><\/div>\n

Methods & Study Design<\/h3>
\n

\u2022 Design\u00a0<\/b><\/span><\/p>\n

This was a prospective observational trial.<\/span><\/p>\n

\u2022 Population\u00a0<\/b><\/span><\/p>\n

Inclusion: spontaneously breathing patients with signs of acute circulatory failure in the ED and ICU of 2 academic hospitals in the US. <\/span><\/p>\n

Exclusion: primary traumatic, cardiogenic, obstructive, or neurogenic shock; age < 18 years old; incarceration; pregnancy; and\/or hospitalization for >36 h; NIPPV; if the clinical team felt that they had active pulmonary edema; or that believed that further IVFs might pose a clinical risk.<\/span><\/p>\n

\u2022 Intervention\u00a0<\/b><\/span><\/p>\n

A NICOM device monitored cardiac index at 1 minute intervals for the duration of the study. Patients had initial cardiac index measurements and IVC videos recorded. Then, after a 3 minute passive leg raise, an additional IVC video was recorded. Lastly, patients received a 500ml normal saline bolus and immediately had a final IVC video recorded. Images were reviewed after the study to determine the cIVC.\u00a0<\/span>\u00a0<\/span><\/p>\n

\u2022 Outcomes\u00a0\u00a0<\/b><\/span><\/p>\n

The primary outcome was fluid responsiveness, defined as a \u2265 10% increase in cardiac index.<\/span><\/p>\n<\/div><\/div>\n

Results<\/h3>
\n

A cIVC of 25% provided maximum sensitivity (87%) and specificity (81%) in identifying fluid responders. However, as you can see in the figure below, there were several patients with cIVC below 25% who\u00a0were<\/em> fluid responders, and several patients with cIVC above 25% who\u00a0were not<\/em> fluid responders.\u00a0<\/span><\/p>\n

\"IVC
Corl et al.<\/figcaption><\/figure>\n<\/div><\/div>\n

Strength & Limitations<\/h3>
\n

Strengths: The prospective study design reduces bias and confounding factors. Few studies have examined fluid responsiveness in non-ventilated patients, and this adds to the growing body of evidence in this population.\u00a0<\/span><\/p>\n

Limitations: This study primarily included patients with severe sepsis\/septic shock and DKA\/HHS. This limits the generalizability of the findings to other forms of acute circulatory failure. Furthermore, fluid responsiveness was measured once immediately following the bolus. Monitoring the patients\u2019 clinical status over several hours or for the duration of the ICU admission may have provided additional, clinically relevant data regarding fluid resuscitation. <\/span><\/p>\n<\/div><\/div>\n

Authors Conclusion<\/h3>
\n

\u201ccIVC, as measured by POCUS, is able to detect fluid responsiveness and may be used to guide IVF resuscitation among spontaneously breathing critically-ill patients.\u201d<\/span><\/p>\n<\/div><\/div>\n

Our Conclusion<\/h3>
\n

In spontaneously breathing patients with distributive shock, cIVC can be a useful tool in identifying fluid responsiveness, with the caveat that a minority of patients with minimal IVC collapsibility may still be fluid responders and those with significant IVC collapsibility may not be fluid responders. There is certainly a trend toward a collapsible IVC identifying fluid responders, but the outliers in this study should be taken into account. IVC, along with history, exam and bedside echo, can be used to identify which patients may need more IV fluid resuscitation.\u00a0<\/span><\/p>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n

\n
\n
\n

The Bottom Line <\/h1>\n

IVC collapsibility >25% predicts fluid responsiveness in spontaneously breathing patients with distributive shock most of the time<\/em>, but should not be solely relied upon.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

\n
\n
\n

Authors<\/h3>
\n

This post was written by Aaser Ali, MS4 at UCSD School of Medicine, Charles Murchison, MD and Amir Aminlari, MD.\u00a0<\/p>\n<\/div><\/div>\n

References <\/h3>
\n
    \n
  1. \n

    Corl KA, George NR, Romanoff J, et al. Inferior vena cava collapsibility detects fluid responsiveness among spontaneously breathing critically-ill patients. J Crit Care. 2017;41:130-137.<\/span><\/p>\n<\/li>\n

  2. \n

    Machare-Delgado E, Decaro M, Marik PE. Inferior vena cava variation compared to<\/span>
    <\/span>pulse contour analysis as predictors of fluid responsiveness: a prospective cohort<\/span>
    <\/span>study. Intensive Care Med 2011;26(2):116\u201324.<\/span><\/p>\n<\/li>\n

  3. \n

    Muller L, Bobbia X, Toumi M, et al. Respiratory variations of inferior vena cava diam-<\/span>
    <\/span>eter to predict fluid responsiveness in spontaneously breathing patients with acute<\/span>
    <\/span>circulatory failure: need for a cautious use. Crit Care 2012;16(5):R188.<\/span><\/p>\n<\/li>\n<\/ol>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"Background Fluid responsiveness is key in guiding the resuscitation of critically ill patients, and both under and over resuscitation can lead to poor clinical outcomes. Vitals and physical exam are not always reliable in determining fluid responsiveness. The search for a quick, easy and accurate diagnostic test to determine fluid responsiveness is ongoing. IVC collapsibility …

    Continue reading \"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients?\"<\/span><\/a><\/p>","protected":false},"author":2,"featured_media":1799,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[5],"tags":[75,74],"class_list":["post-1794","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-journal-club","tag-fluid-responsiveness","tag-ivc-ultrasound"],"yoast_head":"\nCan IVC collapsibility predict fluid responsiveness in non-ventilated patients? - UCSD Ultrasound<\/title>\n<meta name=\"description\" content=\"What is the most sensitive view in the FAST exam? We review the recent literature on the subject.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients? - UCSD Ultrasound\" \/>\n<meta property=\"og:description\" content=\"What is the most sensitive view in the FAST exam? We review the recent literature on the subject.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/\" \/>\n<meta property=\"og:site_name\" content=\"UCSD Ultrasound\" \/>\n<meta property=\"article:published_time\" content=\"2020-08-26T08:00:29+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-05-04T16:56:32+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/i0.wp.com\/emultrasound.ucsd.edu\/wp-content\/uploads\/2020\/08\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1\" \/>\n\t<meta property=\"og:image:width\" content=\"630\" \/>\n\t<meta property=\"og:image:height\" content=\"427\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"UCSD Ultrasound\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@ucsdsono\" \/>\n<meta name=\"twitter:site\" content=\"@ucsdsono\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"UCSD Ultrasound\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/\"},\"author\":{\"name\":\"UCSD Ultrasound\",\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/#\\\/schema\\\/person\\\/b29066b4104637bc43b8a1c79c2cda34\"},\"headline\":\"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients?\",\"datePublished\":\"2020-08-26T08:00:29+00:00\",\"dateModified\":\"2021-05-04T16:56:32+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/\"},\"wordCount\":723,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/i0.wp.com\\\/emultrasound.ucsd.edu\\\/wp-content\\\/uploads\\\/2020\\\/08\\\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1\",\"keywords\":[\"fluid responsiveness\",\"IVC ultrasound\"],\"articleSection\":[\"Journal Club\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/\",\"url\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/\",\"name\":\"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients? - UCSD Ultrasound\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/i0.wp.com\\\/emultrasound.ucsd.edu\\\/wp-content\\\/uploads\\\/2020\\\/08\\\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1\",\"datePublished\":\"2020-08-26T08:00:29+00:00\",\"dateModified\":\"2021-05-04T16:56:32+00:00\",\"description\":\"What is the most sensitive view in the FAST exam? We review the recent literature on the subject.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/#primaryimage\",\"url\":\"https:\\\/\\\/i0.wp.com\\\/emultrasound.ucsd.edu\\\/wp-content\\\/uploads\\\/2020\\\/08\\\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1\",\"contentUrl\":\"https:\\\/\\\/i0.wp.com\\\/emultrasound.ucsd.edu\\\/wp-content\\\/uploads\\\/2020\\\/08\\\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1\",\"width\":630,\"height\":427,\"caption\":\"ivc ultrasound\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/2020\\\/08\\\/26\\\/ivc-collapsibility\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/#website\",\"url\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/\",\"name\":\"UCSD Ultrasound\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/#organization\",\"name\":\"UCSD Ultrasound\",\"url\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/i0.wp.com\\\/emultrasound.sdsc.edu\\\/wp-content\\\/uploads\\\/2017\\\/05\\\/Site-Icon.png?fit=500%2C500&ssl=1\",\"contentUrl\":\"https:\\\/\\\/i0.wp.com\\\/emultrasound.sdsc.edu\\\/wp-content\\\/uploads\\\/2017\\\/05\\\/Site-Icon.png?fit=500%2C500&ssl=1\",\"width\":500,\"height\":500,\"caption\":\"UCSD Ultrasound\"},\"image\":{\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/x.com\\\/ucsdsono\",\"https:\\\/\\\/www.youtube.com\\\/channel\\\/UCUfU0zba7gBUhMWngISV4lw\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/#\\\/schema\\\/person\\\/b29066b4104637bc43b8a1c79c2cda34\",\"name\":\"UCSD Ultrasound\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/17bb7447707466629ca47231e7c8d1bc5b82ab3236e9c578ace4202055df2b2b?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/17bb7447707466629ca47231e7c8d1bc5b82ab3236e9c578ace4202055df2b2b?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/17bb7447707466629ca47231e7c8d1bc5b82ab3236e9c578ace4202055df2b2b?s=96&d=mm&r=g\",\"caption\":\"UCSD Ultrasound\"},\"url\":\"https:\\\/\\\/emultrasound.ucsd.edu\\\/index.php\\\/author\\\/em-admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients? - UCSD Ultrasound","description":"What is the most sensitive view in the FAST exam? We review the recent literature on the subject.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/","og_locale":"en_US","og_type":"article","og_title":"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients? - UCSD Ultrasound","og_description":"What is the most sensitive view in the FAST exam? We review the recent literature on the subject.","og_url":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/","og_site_name":"UCSD Ultrasound","article_published_time":"2020-08-26T08:00:29+00:00","article_modified_time":"2021-05-04T16:56:32+00:00","og_image":[{"width":630,"height":427,"url":"https:\/\/i0.wp.com\/emultrasound.ucsd.edu\/wp-content\/uploads\/2020\/08\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1","type":"image\/jpeg"}],"author":"UCSD Ultrasound","twitter_card":"summary_large_image","twitter_creator":"@ucsdsono","twitter_site":"@ucsdsono","twitter_misc":{"Written by":"UCSD Ultrasound","Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/#article","isPartOf":{"@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/"},"author":{"name":"UCSD Ultrasound","@id":"https:\/\/emultrasound.ucsd.edu\/#\/schema\/person\/b29066b4104637bc43b8a1c79c2cda34"},"headline":"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients?","datePublished":"2020-08-26T08:00:29+00:00","dateModified":"2021-05-04T16:56:32+00:00","mainEntityOfPage":{"@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/"},"wordCount":723,"commentCount":0,"publisher":{"@id":"https:\/\/emultrasound.ucsd.edu\/#organization"},"image":{"@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/#primaryimage"},"thumbnailUrl":"https:\/\/i0.wp.com\/emultrasound.ucsd.edu\/wp-content\/uploads\/2020\/08\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1","keywords":["fluid responsiveness","IVC ultrasound"],"articleSection":["Journal Club"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/","url":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/","name":"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients? - UCSD Ultrasound","isPartOf":{"@id":"https:\/\/emultrasound.ucsd.edu\/#website"},"primaryImageOfPage":{"@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/#primaryimage"},"image":{"@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/#primaryimage"},"thumbnailUrl":"https:\/\/i0.wp.com\/emultrasound.ucsd.edu\/wp-content\/uploads\/2020\/08\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1","datePublished":"2020-08-26T08:00:29+00:00","dateModified":"2021-05-04T16:56:32+00:00","description":"What is the most sensitive view in the FAST exam? We review the recent literature on the subject.","breadcrumb":{"@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/#primaryimage","url":"https:\/\/i0.wp.com\/emultrasound.ucsd.edu\/wp-content\/uploads\/2020\/08\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1","contentUrl":"https:\/\/i0.wp.com\/emultrasound.ucsd.edu\/wp-content\/uploads\/2020\/08\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1","width":630,"height":427,"caption":"ivc ultrasound"},{"@type":"BreadcrumbList","@id":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/08\/26\/ivc-collapsibility\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/emultrasound.ucsd.edu\/"},{"@type":"ListItem","position":2,"name":"Can IVC collapsibility predict fluid responsiveness in non-ventilated patients?"}]},{"@type":"WebSite","@id":"https:\/\/emultrasound.ucsd.edu\/#website","url":"https:\/\/emultrasound.ucsd.edu\/","name":"UCSD Ultrasound","description":"","publisher":{"@id":"https:\/\/emultrasound.ucsd.edu\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/emultrasound.ucsd.edu\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/emultrasound.ucsd.edu\/#organization","name":"UCSD Ultrasound","url":"https:\/\/emultrasound.ucsd.edu\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/emultrasound.ucsd.edu\/#\/schema\/logo\/image\/","url":"https:\/\/i0.wp.com\/emultrasound.sdsc.edu\/wp-content\/uploads\/2017\/05\/Site-Icon.png?fit=500%2C500&ssl=1","contentUrl":"https:\/\/i0.wp.com\/emultrasound.sdsc.edu\/wp-content\/uploads\/2017\/05\/Site-Icon.png?fit=500%2C500&ssl=1","width":500,"height":500,"caption":"UCSD Ultrasound"},"image":{"@id":"https:\/\/emultrasound.ucsd.edu\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/x.com\/ucsdsono","https:\/\/www.youtube.com\/channel\/UCUfU0zba7gBUhMWngISV4lw"]},{"@type":"Person","@id":"https:\/\/emultrasound.ucsd.edu\/#\/schema\/person\/b29066b4104637bc43b8a1c79c2cda34","name":"UCSD Ultrasound","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/17bb7447707466629ca47231e7c8d1bc5b82ab3236e9c578ace4202055df2b2b?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/17bb7447707466629ca47231e7c8d1bc5b82ab3236e9c578ace4202055df2b2b?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/17bb7447707466629ca47231e7c8d1bc5b82ab3236e9c578ace4202055df2b2b?s=96&d=mm&r=g","caption":"UCSD Ultrasound"},"url":"https:\/\/emultrasound.ucsd.edu\/index.php\/author\/em-admin\/"}]}},"jetpack_featured_media_url":"https:\/\/i0.wp.com\/emultrasound.ucsd.edu\/wp-content\/uploads\/2020\/08\/a7e0cd98e050fc18b48fbd68a00264_big_gallery.jpeg?fit=630%2C427&ssl=1","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/posts\/1794","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/comments?post=1794"}],"version-history":[{"count":11,"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/posts\/1794\/revisions"}],"predecessor-version":[{"id":2005,"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/posts\/1794\/revisions\/2005"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/media\/1799"}],"wp:attachment":[{"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/media?parent=1794"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/categories?post=1794"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/emultrasound.ucsd.edu\/index.php\/wp-json\/wp\/v2\/tags?post=1794"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}