Peripheral Intravenous Volume Analysis (PIVA) for Quantitating Volume Overload in Patients Hospitalized With Acute Decompensated Heart Failure-A Pilot Study

Merrick Miles; Bret D Alvis; Kyle Hocking; Franz Baudenbacher; Christy Guth; Joann Lindenfeld; Colleen Brophy; Susan Eagle

doi:10.1016/j.cardfail.2018.05.003

Peripheral Intravenous Volume Analysis (PIVA) for Quantitating Volume Overload in Patients Hospitalized With Acute Decompensated Heart Failure-A Pilot Study

J Card Fail. 2018 Aug;24(8):525-532. doi: 10.1016/j.cardfail.2018.05.003. Epub 2018 May 16.

Authors

Merrick Miles¹, Bret D Alvis², Kyle Hocking³, Franz Baudenbacher⁴, Christy Guth³, Joann Lindenfeld⁵, Colleen Brophy³, Susan Eagle⁶

Affiliations

¹ Vanderbilt University Medical Center, Department of Anesthesiology, Division of Critical Care, Nashville, Tennessee.
² Vanderbilt University Medical Center, Department of Anesthesiology, Division of Critical Care, Nashville, Tennessee. Electronic address: bret.d.alvis@vanderbilt.edu.
³ Vanderbilt University Medical Center, Department of Surgery, Nashville, Tennessee.
⁴ Vanderbilt University, Institute for Integrative Biosystems Research and Education (VIIBRE) Department of Engineering, Nashville, Tennessee.
⁵ Vanderbilt University Medical Center, Department of Medicine, Division of Cardiology, Nashville, Tennessee.
⁶ Vanderbilt University Medical Center, Department of Anesthesiology, Division of Cardiac & Thoracic Anesthesia, Nashville, Tennessee.

PMID: 29777760
DOI: 10.1016/j.cardfail.2018.05.003

Abstract

Background: To determine the feasibility of peripheral intravenous volume analysis (PIVA) of venous waveforms for assessing volume overload in patients admitted to the hospital with acute decompensated heart failure (ADHF).

Methods: Venous waveforms were captured from a peripheral intravenous catheter in subjects admitted for ADHF and healthy age-matched controls. Admission PIVA signal, brain natriuretic peptide, and chest radiographic measurements were related to the net volume removed during diuresis.

Results: ADHF patients had a significantly greater PIVA signal on admission compared with the control group (P = .0013, n = 18). At discharge, ADHF patients had a PIVA signal similar to the control group. PIVA signal, not brain natriuretic peptide or chest radiographic measures, accurately predicted the amount of volume removed during diuresis (R² = 0.781, n = 14). PIVA signal at time of discharge greater than 0.20, demonstrated 83.3% 120-day readmission rate.

Conclusions: This study demonstrates the feasibility of PIVA for assessment of volume overload in patients admitted to the hospital with ADHF.

Keywords: Acute heart failure; chronic heart failure; venous; venous waveform; volume overload.

Publication types

Observational Study

MeSH terms

Acute Disease
Blood Volume / physiology*
Catheterization, Peripheral
Diuresis / physiology
Feasibility Studies
Female
Heart Failure / diagnosis
Heart Failure / physiopathology*
Humans
Inpatients*
Male
Middle Aged
Pilot Projects
Stroke Volume / physiology*
Veins / physiopathology*