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Right internal jugular vein distensibility appears to be a surrogate marker for inferior vena cava vein distensibility for evaluating fluid responsiveness.

Broilo F, Meregalli A, Friedman G - Rev Bras Ter Intensiva (2015 Jul-Sep)

Bottom Line: Using 12% for ∆DIVC, indicating fluid responsiveness by method (B), 14 patients were responders and 32 measurements showed agreement (weighted Kappa = 0.65).The area under the ROC curve was 0.903 (95%CI 0.765 - 0.973; cut-off value = 11.86).The respiratory variation of the inferior vena cava and the right internal jugular veins are correlated and showed significant agreement.

View Article: PubMed Central - PubMed

Affiliation: Unidade de Terapia Intensiva Central, Complexo Hospitalar Santa Casa, Porto Alegre, RS, BR.

ABSTRACT

Objective: To investigate whether the respiratory variation of the inferior vena cava diameter (∆DIVC) and right internal jugular vein diameter (∆DRIJ) are correlated in mechanically ventilated patients.

Methods: This study was a prospective clinical analysis in an intensive care unit at a university hospital. Thirty-nine mechanically ventilated patients with hemodynamic instability were included. ∆DIVC and ∆DRIJ were assessed by echography. Vein distensibility was calculated as the ratio of (A) Dmax--Dmin/Dmin and (B) Dmax--Dmin/ mean of Dmax--Dmin and expressed as a percentage.

Results: ∆DIVC and ∆DRIJ were correlated by both methods: (A) r = 0.34, p = 0.04 and (B) r = 0.51, p = 0.001. Using 18% for ∆DIVC, indicating fluid responsiveness by method (A), 16 patients were responders and 35 measurements showed agreement (weighted Kappa = 0.80). The area under the ROC curve was 0.951 (95%CI 0.830 - 0.993; cutoff = 18.92). Using 12% for ∆DIVC, indicating fluid responsiveness by method (B), 14 patients were responders and 32 measurements showed agreement (weighted Kappa = 0.65). The area under the ROC curve was 0.903 (95%CI 0.765 - 0.973; cut-off value = 11.86).

Conclusion: The respiratory variation of the inferior vena cava and the right internal jugular veins are correlated and showed significant agreement. Evaluation of right internal jugular vein distensibility appears to be a surrogate marker for inferior vena cava vein distensibility for evaluating fluid responsiveness.

No MeSH data available.


Related in: MedlinePlus

Pearson correlation after logarithmic transformation of the distensibility of theinferior vena cava and of the right internal jugular vein. ∆DIVC - distensibilityof inferior vena cava; ∆DRIJV - distensibility right internal jugular vein.
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f02: Pearson correlation after logarithmic transformation of the distensibility of theinferior vena cava and of the right internal jugular vein. ∆DIVC - distensibilityof inferior vena cava; ∆DRIJV - distensibility right internal jugular vein.

Mentions: The IVC anteroposterior diameter during inspiration was 21 ± 6mm, and duringexpiration was 18 ± 6mm (p < 0.0001). The inspiratory RIJV diameter was 11± 4mm and expiratory was 9 ± 4mm (p < 0.0001). ΔDIVC andΔDRIJV were significantly correlated by both calculation methods (Figure 1). Correlations did not have a normaldistribution, but log transformation revealed a highly significant correlation (Figure 2).


Right internal jugular vein distensibility appears to be a surrogate marker for inferior vena cava vein distensibility for evaluating fluid responsiveness.

Broilo F, Meregalli A, Friedman G - Rev Bras Ter Intensiva (2015 Jul-Sep)

Pearson correlation after logarithmic transformation of the distensibility of theinferior vena cava and of the right internal jugular vein. ∆DIVC - distensibilityof inferior vena cava; ∆DRIJV - distensibility right internal jugular vein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4592113&req=5

f02: Pearson correlation after logarithmic transformation of the distensibility of theinferior vena cava and of the right internal jugular vein. ∆DIVC - distensibilityof inferior vena cava; ∆DRIJV - distensibility right internal jugular vein.
Mentions: The IVC anteroposterior diameter during inspiration was 21 ± 6mm, and duringexpiration was 18 ± 6mm (p < 0.0001). The inspiratory RIJV diameter was 11± 4mm and expiratory was 9 ± 4mm (p < 0.0001). ΔDIVC andΔDRIJV were significantly correlated by both calculation methods (Figure 1). Correlations did not have a normaldistribution, but log transformation revealed a highly significant correlation (Figure 2).

Bottom Line: Using 12% for ∆DIVC, indicating fluid responsiveness by method (B), 14 patients were responders and 32 measurements showed agreement (weighted Kappa = 0.65).The area under the ROC curve was 0.903 (95%CI 0.765 - 0.973; cut-off value = 11.86).The respiratory variation of the inferior vena cava and the right internal jugular veins are correlated and showed significant agreement.

View Article: PubMed Central - PubMed

Affiliation: Unidade de Terapia Intensiva Central, Complexo Hospitalar Santa Casa, Porto Alegre, RS, BR.

ABSTRACT

Objective: To investigate whether the respiratory variation of the inferior vena cava diameter (∆DIVC) and right internal jugular vein diameter (∆DRIJ) are correlated in mechanically ventilated patients.

Methods: This study was a prospective clinical analysis in an intensive care unit at a university hospital. Thirty-nine mechanically ventilated patients with hemodynamic instability were included. ∆DIVC and ∆DRIJ were assessed by echography. Vein distensibility was calculated as the ratio of (A) Dmax--Dmin/Dmin and (B) Dmax--Dmin/ mean of Dmax--Dmin and expressed as a percentage.

Results: ∆DIVC and ∆DRIJ were correlated by both methods: (A) r = 0.34, p = 0.04 and (B) r = 0.51, p = 0.001. Using 18% for ∆DIVC, indicating fluid responsiveness by method (A), 16 patients were responders and 35 measurements showed agreement (weighted Kappa = 0.80). The area under the ROC curve was 0.951 (95%CI 0.830 - 0.993; cutoff = 18.92). Using 12% for ∆DIVC, indicating fluid responsiveness by method (B), 14 patients were responders and 32 measurements showed agreement (weighted Kappa = 0.65). The area under the ROC curve was 0.903 (95%CI 0.765 - 0.973; cut-off value = 11.86).

Conclusion: The respiratory variation of the inferior vena cava and the right internal jugular veins are correlated and showed significant agreement. Evaluation of right internal jugular vein distensibility appears to be a surrogate marker for inferior vena cava vein distensibility for evaluating fluid responsiveness.

No MeSH data available.


Related in: MedlinePlus