Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Original Article

Volume 12, Number 3, March 2020, pages 150-156


Collapsibility of the Right Internal Jugular Vein Predicts Responsiveness to Fluid Administration in Patients Receiving Pressure Support Ventilation: A Prospective Cohort Study

Figures

Figure 1.
Figure 1. Assessment of antero-posterior diameter of the right internal jugular vein by ultrasonography. The diameter was measured 2 cm above the level of the clavicle.
Figure 2.
Figure 2. The ultrasound short axis view at the closest point where the subclavian vein (SCV) crosses the clavicle.
Figure 3.
Figure 3. Receiver operating characteristic (ROC) curves of baseline collapsibility of the right internal jugular vein (RIJV) and inferior vena cava (IVC) diameters.

Tables

Table 1. Main Characteristics of the Responders and Non-Responders
 
Responders (n = 18)Non-responders (n = 16)P value
The results are expressed as the median (25-75%). PBW: predicted body weight; PEEP: positive end expiratory pressure; BSA: body surface area; SV: stroke volume; SVV: stroke volume variation; CSA: cross-sectional area; RIJV: right internal jugular vein; LIJV: left internal jugular vein; RSCV: right subclavian vein; LSCV: left subclavian vein; IVC: inferior vena cava.
Patients characteristics
  Age (years)70 (66 - 77)76 (71 - 84)0.047
  Gender (male/female)12/69/70.552
  Height (cm)165 (154 - 168)156 (152 - 169)0.332
  Weight (kg)60 (56 - 69)54 (48 - 61)0.097
Diagnosis of acute circulatory failure
  Septic shock12110.915
  Hemorrhagic shock300.099
  Acute mesenteric ischemia110.966
  Post-resuscitation syndrome110.966
  Others130.253
Vasopressor use
  Norepinephrine1080.765
  Norepinephrine and/or other vasoactive agents750.662
  None130.253
Respiratory parameters
  Tidal volume/PBW (mL)9.5 (8.0 - 10.9)9.5 (7.9 - 11.8)0.863
  Respiratory rate17 (13 - 25)18 (12 - 22)0.616
  Pressure support (cm H2O)7 (8.5 - 11.5)8 (5 - 10)0.084
  PEEP (cm H2O)7 (5 - 8)5 (5 - 8.5)0.658
  Minute ventilation (L/min)8.6 (7.0 - 13.2)7.7 (6.9 - 9.6)0.36
Hemodynamic parameters
  Systolic arterial pressure (mm Hg)98 (84 - 108)120 (107 - 125)0.01
  Mean arterial pressure (mm Hg)63 (58 - 74)73 (62 - 79)0.164
  Diastolic arterial pressure (mm Hg)47 (44 - 54)51 (44 - 53)0.876
  Pulse pressure (mm Hg)44 (40 - 59)67 (60 - 76)0.002
  Heart rate (bpm)97 (90 - 110)88 (76 - 96)0.03
  Cardiac output (L/min)4.1 (3.8 - 6.0)4.0 (3.6 - 5.8)0.653
  Cardiac index (L/min/BSA)2.7 (2.5 - 3.5)2.7 (2.5 - 3.3)0.903
  SV (mL)45 (39 - 55)51 (43 - 58)0.369
  SVV (%)16 (12 - 21)7 (5 - 12)0.003
Collapsibility (%)
  RIJV diameter16.1 (12.2 - 23.9)5.7 (1.4 - 9.0)< 0.001
  RIJV CSA26.6 (20.7 - 38.2)9.1 (4.3 - 15.3)0.002
  LIJV diameter13.4 (5.2 - 26.7)8.9 (4.4 - 25.2)0.523
  LIJV CSA17.7 (8.2 - 28.3)16.5 (4.4 - 29.6)0.569
  RSCV diameter7.3 (3.0 - 14.8)4.4 (2.9 - 8.2)0.3
  RSCV CSA15.2 (8.6 - 31.0)11.5 (8.8 - 15.3)0.301
  LSCV diameter13.0 (6.9 - 19.3)10.2 (3.6 - 17.2)0.617
  LSCV CSA18.6 (10.0 - 28.1)13.9 (5.8 - 26.4)0.309
  IVC diameter28.9 (16.3 - 39.5)25.1 (9.62 - 37.1)0.484

 

Table 2. The Area Under the Receiver Operating Characteristic Curves (95% CI)
 
CI: confidence interval; CSA: cross-sectional area; RIJV: right internal jugular vein; LIJV: left internal jugular vein; RSCV: right subclavian vein; LSCV: left subclavian vein; IVC: inferior vena cava; SVV: stroke volume variation.
Collapsibility
  RIJV diameter0.88 (0.75 - 0.99)
  RIJV CSA0.82 (0.67 - 0.97)
  LIJV diameter0.57 (0.37 - 0.77)
  LIJV CSA0.56 (0.35 - 0.77)
  RSCV diameter0.61 (0.41 - 0.80)
  RSCV CSA0.61 (0.41 - 0.80)
  LSCV diameter0.55 (0.35 - 0.76)
  LSCV CSA0.60 (0.40 - 0.81)
  IVC diameter0.57 (0.37 - 0.77)
Hemodynamic parameter
  SVV0.80 (0.64 - 0.96)