Cardiac Variation of Internal Jugular Vein as a Marker of Volume Change in Hemorrhagic Shock.


Journal

Shock (Augusta, Ga.)
ISSN: 1540-0514
Titre abrégé: Shock
Pays: United States
ID NLM: 9421564

Informations de publication

Date de publication:
12 2020
Historique:
pubmed: 21 5 2020
medline: 7 10 2021
entrez: 21 5 2020
Statut: ppublish

Résumé

Fluid resuscitation, which is critical to counter acute hemorrhagic shock, requires prompt and accurate intravascular volume estimation for optimal fluid administration. This study aimed to evaluate whether cardiac variation of internal jugular vein (IJV), evaluated by ultrasonography, could detect hypovolemic status and predict response to fluid resuscitation. Patients undergoing autologous blood transfusion for elective surgery who were prospectively enrolled at the study blood donation center between August 2014 and January 2015. Vertical B-mode ultrasonography movies of IJV were recorded at five timepoints during blood donation: before donation, during donation, end of donation, end of fluid replacement, and after hemostasis. Cardiac variation of the IJV area and circumference were objectively measured using an automated extraction program together with blood pressure and heart rate. A total of 140 patients were screened, and data from 104 patients were included in the final analyses. Among the variables analyzed, only collapse index area and collapse index circumference could detect both intravascular volume loss and response to fluid administration. Cardiac variation of IJV may be a reliable indicator of intravascular volume loss and response to fluid administration in hemorrhagic shock.

Sections du résumé

BACKGROUND
Fluid resuscitation, which is critical to counter acute hemorrhagic shock, requires prompt and accurate intravascular volume estimation for optimal fluid administration. This study aimed to evaluate whether cardiac variation of internal jugular vein (IJV), evaluated by ultrasonography, could detect hypovolemic status and predict response to fluid resuscitation.
METHODS
Patients undergoing autologous blood transfusion for elective surgery who were prospectively enrolled at the study blood donation center between August 2014 and January 2015. Vertical B-mode ultrasonography movies of IJV were recorded at five timepoints during blood donation: before donation, during donation, end of donation, end of fluid replacement, and after hemostasis. Cardiac variation of the IJV area and circumference were objectively measured using an automated extraction program together with blood pressure and heart rate.
RESULTS
A total of 140 patients were screened, and data from 104 patients were included in the final analyses. Among the variables analyzed, only collapse index area and collapse index circumference could detect both intravascular volume loss and response to fluid administration.
CONCLUSIONS
Cardiac variation of IJV may be a reliable indicator of intravascular volume loss and response to fluid administration in hemorrhagic shock.

Identifiants

pubmed: 32433209
doi: 10.1097/SHK.0000000000001548
pii: 00024382-202012000-00003
doi:

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

717-722

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Auteurs

Kurato Tokunaga (K)

Department of Acute Medicine, The University of Tokyo Hospital, Tokyo, Japan.

Kensuke Nakamura (K)

Department of Acute Medicine, The University of Tokyo Hospital, Tokyo, Japan.

Ryota Inokuchi (R)

Department of Acute Medicine, The University of Tokyo Hospital, Tokyo, Japan.

Naoki Hayase (N)

Department of Acute Medicine, The University of Tokyo Hospital, Tokyo, Japan.

Rui Terada (R)

Department of Blood Transfusion, The University of Tokyo Hospital, Tokyo, Japan.

Yuji Tomioka (Y)

Department of Precision Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.

Toshiyuki Ikeda (T)

Department of Blood Transfusion, The University of Tokyo Hospital, Tokyo, Japan.

Etsuko Kobayashi (E)

Department of Precision Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.

Hitoshi Okazaki (H)

Department of Blood Transfusion, The University of Tokyo Hospital, Tokyo, Japan.

Ichiro Sakuma (I)

Department of Precision Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.

Kent Doi (K)

Department of Acute Medicine, The University of Tokyo Hospital, Tokyo, Japan.

Naoto Morimura (N)

Department of Acute Medicine, The University of Tokyo Hospital, Tokyo, Japan.

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