IVC Window Agreement Study
June 24, 2026 updated by: Mehmet Ali Aslaner, Gazi University
Are Subcostal, Transhepatic, and Coronal Windows Interchangeable for IVC Ultrasonography? A Multicenter Prospective Agreement Study
Ultrasonographic evaluation of the inferior vena cava (IVC) is widely used in emergency and critical care settings for noninvasive assessment of intravascular volume status.
The subcostal (SC) window is the standard approach; however, it is frequently limited by obesity, bowel distension, or postoperative anatomical changes.
In such cases, the right coronal (RC) and anterior transhepatic (aTH) windows have been proposed as alternatives.
Study Overview
Status
Not yet recruiting
Conditions
Detailed Description
The existing literature presents conflicting results regarding the interchangeability of these windows. Several studies report significant discrepancies between SC and RC measurements, while others demonstrate strong agreement. Direct comparison of the SC and aTH windows has received considerably less attention, with only a single prospective study to date reporting reliable agreement between these approaches under standardized imaging criteria.
Methodological heterogeneity, most likely arising from an unstandardized imaging technique, underlies much of the observed discordance. As a result, clinicians lack clear guidance on whether alternative windows can reliably substitute for the SC approach across diverse clinical settings.
Study Type
Observational
Enrollment (Estimated)
900
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Sampling Method
Probability Sample
Study Population
Adult patients (≥18 years) requiring ultrasonographic assessment of intravascular volume status in the emergency departments, intensive care units, and other acute care settings.
Description
Inclusion Criteria:
- Adult patients (≥18 years) requiring ultrasonographic assessment of intravascular volume status will be consecutively enrolled.
Exclusion Criteria:
- Pregnancy, refusal to participate, and inability to obtain any IVC image via the SC approach.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
|---|
|
Patients who need volume status assessment
Patients who need volume status assessment in the emergency, critical, or acute care settings
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The intermethod agreement of IVC diameter and collapsibility index measurements
Time Frame: 90 days
|
The intermethod agreement of IVC diameter and collapsibility index measurements obtained from the subcostal (SC), anterior transhepatic (aTH), and right coronal (RC) ultrasonographic windows under a standardized imaging protocol, and to determine whether aTH and RC windows can serve as reliable alternatives to the SC approach across diverse clinical settings and operator profiles.
|
90 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- La Via L, Astuto M, Dezio V, Muscara L, Palella S, Zawadka M, Vignon P, Sanfilippo F. Agreement between subcostal and transhepatic longitudinal imaging of the inferior vena cava for the evaluation of fluid responsiveness: A systematic review. J Crit Care. 2022 Oct;71:154108. doi: 10.1016/j.jcrc.2022.154108. Epub 2022 Jul 5.
- Kulkarni AP, Janarthanan S, Harish MM, Suhail S, Chaudhari H, Agarwal V, Patil VP, Divatia JV. Agreement between inferior vena cava diameter measurements by subxiphoid versus transhepatic views. Indian J Crit Care Med. 2015 Dec;19(12):719-22. doi: 10.4103/0972-5229.171390.
- Albayrak AK, Aslaner MA, Korkak OF, Bildik F. Reliability of Alternative Sonographic Approaches for Inferior Vena Cava: Comparison of Subcostal, Transhepatic, and Coronal Windows. J Emerg Med. 2026 Jan;80:64-73. doi: 10.1016/j.jemermed.2025.10.024. Epub 2025 Oct 23.
Helpful Links
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Estimated)
August 1, 2026
Primary Completion (Estimated)
December 30, 2026
Study Completion (Estimated)
December 30, 2026
Study Registration Dates
First Submitted
June 24, 2026
First Submitted That Met QC Criteria
June 24, 2026
First Posted (Actual)
June 30, 2026
Study Record Updates
Last Update Posted (Actual)
June 30, 2026
Last Update Submitted That Met QC Criteria
June 24, 2026
Last Verified
June 1, 2026
More Information
Terms related to this study
Other Study ID Numbers
- Gazi U - IVC
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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