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

Abstract

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.

Assessment of Phasic Changes of Vascular Size by Automated Edge Tracking-State of the Art and Clinical Perspectives

“…Alternative methods to assess phasic changes of vascular size have also been applied or developed by other colleagues (35)(36)(37). Specifically, a method widely used in echocardiography is based on tracking the speckle noise (38), i.e., a random mixture of interference patterns and US reflections characterizing each region of the tissue (like as a fingerprint) that is relatively stable on consecutive frames, allowing the region to be traced from one frame to the next.…”

Inferior Vena Cava Edge Tracking Echocardiography: A Promising Tool with Applications in Multiple Clinical Settings

“…Both the long and short axis view have been investigated by our research group [ 14 , 24 ]. While different methods have been presented in the literature (long axis [ 17 ], short axis [ 16 , 32 , 33 ], the current dissertation is limited to those techniques more efficient in terms of computational costs (that could thus be promptly implemented in clinical practice) and with stable data processing [ 14 , 32 ]. Several potential advantages may be present with our suggested methods.…”

The role of internal jugular vein Doppler ultrasonography in predicting hypovolemic shock in polytrauma patients

“…Nevertheless, it is easier to assess the internal jugular vein (IJV) IJV than the IVC. In this regard, respiratory changes in the IJV are helpful for evaluating intravascular fluid status [7,16].…”

“…Although laboratory methods, such as evaluating blood lactate levels and the blood base deficit, have good diagnostic accuracy, they are usually time-consuming and some of these methods lack reliability. Therefore, diagnosing a hypovolemic condition-especially in the early stages of hemorrhagic shock-and occult bleeding based on clinical examinations, vital signs, and laboratory tests can be challenging [ 6 , 7 ].…”