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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

Receiver operating characteristic curve analysis of the right internal jugularvein distensibility index in predicting fluid responsiveness based on inferiorvena cava distensibility values of 18% by method A and 12% by method B. The areaunder the ROC curve was 0.951 (95%CI 0.830 - 0.993) and 0.903 (95%CI 0.765 -0.973), respectively. ∆DRIJV - distensibility right internal jugular vein; ∆DIVC -distensibility of inferior vena cava.
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f03: Receiver operating characteristic curve analysis of the right internal jugularvein distensibility index in predicting fluid responsiveness based on inferiorvena cava distensibility values of 18% by method A and 12% by method B. The areaunder the ROC curve was 0.951 (95%CI 0.830 - 0.993) and 0.903 (95%CI 0.765 -0.973), respectively. ∆DRIJV - distensibility right internal jugular vein; ∆DIVC -distensibility of inferior vena cava.

Mentions: ΔDRIJV by method A showed an AUROC of 0.951 (95%CI 0.830 - 0.993) with a cut-offvalue of 18.92 (sensitivity 100%, specificity 78%). ΔDRIJV by method B showed anAUROC of 0.903 (95%CI 0.765 - 0.973) and a cut-off value of 11.86 (sensitivity 100,specificity 72%) (Figure 3).


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)

Receiver operating characteristic curve analysis of the right internal jugularvein distensibility index in predicting fluid responsiveness based on inferiorvena cava distensibility values of 18% by method A and 12% by method B. The areaunder the ROC curve was 0.951 (95%CI 0.830 - 0.993) and 0.903 (95%CI 0.765 -0.973), respectively. ∆DRIJV - distensibility right internal jugular vein; ∆DIVC -distensibility of inferior vena cava.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f03: Receiver operating characteristic curve analysis of the right internal jugularvein distensibility index in predicting fluid responsiveness based on inferiorvena cava distensibility values of 18% by method A and 12% by method B. The areaunder the ROC curve was 0.951 (95%CI 0.830 - 0.993) and 0.903 (95%CI 0.765 -0.973), respectively. ∆DRIJV - distensibility right internal jugular vein; ∆DIVC -distensibility of inferior vena cava.
Mentions: ΔDRIJV by method A showed an AUROC of 0.951 (95%CI 0.830 - 0.993) with a cut-offvalue of 18.92 (sensitivity 100%, specificity 78%). ΔDRIJV by method B showed anAUROC of 0.903 (95%CI 0.765 - 0.973) and a cut-off value of 11.86 (sensitivity 100,specificity 72%) (Figure 3).

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