Abstract
Background. Fluid resuscitation is crucial to counter acute haemorrhagic shock and requires prompt and accurate intravascular volume estimation for optimal fluid administration. This study aimed to evaluate whether cardiac variation of the internal jugular vein (IJV), measured by ultrasound, could detect hypovolemic status and predict response to fluid resuscitation. Methods. Autologous blood transfusion patients for their own elective surgeries were prospectively enrolled at our blood donation centre from August 2014 to January 2015., and movies of vertical B-mode ultrasonography of the IJV were recorded at five points during blood donation, namely, before donation, during donation, end of donation, end of fluid replacement and after hemostasis. Cardiac variation in IJV area and circumference were objectively measured using an automated extraction programme, along with blood pressure and heart rate. Results. We screened 140patients and data from 104 were eventually evaluated. Among the variables analysed, only collapse index area (CIa) and collapse index circumference (CIc) could detect both intravascular volume loss and response to fluid administration Conclusions. The cardiac variation of IJV may be a reliable indicator of intravascular volume loss and response to fluid administration in haemorrhagic shock.
Fluid resuscitation in haemorrhagic shock in combat casualties
