Assessment of the safety and efficacy of bedside ultrasound guidance for inferior vena cava filter placement in critically ill intensive care unit patients.

Inferior vena cava filters (IVCFs) have been used clinically for approximately 45 y, but only a few studies of these devices have involved intensive care unit (ICU) patients who were critically ill and had multiple-organ dysfunction or were otherwise too unstable for transport. The purpose of this research was to assess the tolerability and efficacy of bedside ultrasound-guided IVCF placement in ICU patients. A retrospective analysis of both bedside ultrasound-guided and X-ray-guided ICVF placement was performed from November of 2011 to August of 2013. The total success rate for ultrasound-guided IVCF placement was 93.4%, which included a 96.0% success rate in 25 ICU patients with an average age of 69.46 y. Six-month follow-up studies revealed no significant differences in long-term complications between the ultrasound- and X-ray-guided groups. IVCFs may be safely implanted under ultrasound guidance in a monitored ICU environment. Our conclusion is that patients should be fasting and should receive an enema and that pre-operative surface marking and dynamic monitoring should be employed. Further research is needed to develop specific ultrasound guidelines.