The role of internal jugular vein and inferior vena cava distensibility indices as parameters of fluid responsiveness in mechanically ventilated septic shock patients

Abstract Background Septic shock is one of the most complex hemodynamic failure syndromes. It is the major cause of mortality and morbidity in intensive care unit. Fluid resuscitation is of paramount importance in septic shock. However, its correction should be carefully guided to avoid unnecessary volume expansion. Ultra- sonographic evaluation of fluid responsiveness plays an important role in septic shock. Objectives The objective of the study was to verify the feasibility and usefulness of the internal jugular vein distensibility index in prediction of fluid responsiveness in septic shock patients undergoing mechanical ventilation compared to the inferior vena cava distensibility index. Methodology The study was carried out in Ain Shams University Hospital from February 2019 to November 2019, on twenty patients 20 patients of both sex who were admitted to the intensive care unit and diagnosed as septic shock (sepsisinduced hypotension persisting despite adequate fluid resuscitation and require vasopressors and serum lactate > 2 mmol/ L) As regard the hemodynamic parameters, patients were classified into two groups: Fluid responders and non-fluid responders. Results The study demonstrated that there was a positive correlation between internal jugular vein distensibility index (IJV DI) and inferior vena cava distensibility index (IVC DI) in prediction of fluid responsiveness. IVC DI index cutoff value was > 12.6% with sensitivity 80% and specificity 80% and IJV DI cut off value was >8.4% with sensitivity 86.67% and specificity 80%. Conclusion ultra-sonographic assessment of the internal jugular vein distensibility index (IJV DI) and inferior vena cava distensibility index (IVC DI) are useful dynamic indices in assessment of the intravascular volume state in mechanically ventilated septic shock patients. IJV and IVC show comparable value in the prediction of fluid responsiveness.

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188: INTERNAL JUGULAR VEIN VERSUS INFERIOR VENA CAVA COLLAPSIBILITY INDEX FOR FLUID RESPONSIVENESS

Critical Care Medicine ◽

10.1097/01.ccm.0000508869.99323.f9 ◽

2016 ◽

Vol 44 (12) ◽

pp. 124-124

Author(s):

Murat Haliloglu ◽

Beliz Bilgili ◽

Alper Kararmaz ◽

Ismail Cinel

Keyword(s):

Inferior Vena Cava ◽

Fluid Responsiveness ◽

Internal Jugular Vein ◽

Inferior Vena ◽

Jugular Vein ◽

Vena Cava ◽

Collapsibility Index

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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

Revista Brasileira de Terapia Intensiva ◽

10.5935/0103-507x.20150042 ◽

2015 ◽

Vol 27 (3) ◽

Cited By ~ 9

Author(s):

Fabiano Broilo ◽

Andre Meregalli ◽

Gilberto Friedman

Keyword(s):

Inferior Vena Cava ◽

Fluid Responsiveness ◽

Internal Jugular Vein ◽

Inferior Vena ◽

Jugular Vein ◽

Vena Cava ◽

Surrogate Marker ◽

Cava Vein

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Stroke volume variation compared with inferior vena cava distensibility for prediction of fluid responsiveness in mechanically ventilated patients with septic shock

Research and Opinion in Anesthesia and Intensive Care ◽

10.4103/roaic.roaic_102_18 ◽

2020 ◽

Vol 7 (1) ◽

pp. 84

Author(s):

WaleedS Abd El Hady ◽

AkramM Fayed ◽

MohamedAbd El Aleem Abd El hady ◽

Mourad El Amir Melika

Keyword(s):

Septic Shock ◽

Inferior Vena Cava ◽

Stroke Volume ◽

Fluid Responsiveness ◽

Inferior Vena ◽

Stroke Volume Variation ◽

Vena Cava ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Ventilated Patients

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Role of Inferior Vena Cava Parameters as Predictors of Fluid Responsiveness in Pediatric Septic Shock: A Prospective Study

Journal of Child Science ◽

10.1055/s-0041-1724034 ◽

2021 ◽

Vol 11 (01) ◽

pp. e49-e54

Author(s):

Ahmed Ahmed EL-Nawawy ◽

Omneya Magdy Omar ◽

Hadir Mohamed Hassouna

Keyword(s):

Septic Shock ◽

Inferior Vena Cava ◽

Fluid Responsiveness ◽

Inferior Vena ◽

Vena Cava ◽

Tissue Perfusion ◽

University Hospital ◽

Predict Fluid Responsiveness ◽

Fluid Bolus

AbstractFluid resuscitation is the initial therapy for septic shock worldwide. Prediction of fluid responsiveness is essential for optimizing fluid administration. Only few pediatric studies have evaluated the role of inferior vena cava (IVC) as a reliable predictor of fluid responsiveness. The aim of this study was to evaluate the role of IVC parameters as predictors of fluid responsiveness in children (under the age of 5 years) having septic shock at different times from admission. A prospective observational study included 51 children having septic shock. It was conducted in the nine-bedded pediatric intensive care unit of a university hospital from January 1, 2018, to the August 31, 2018. Echocardiography was used to assess minimal and maximal IVC diameters and its distensibility index with simultaneous assessment of stroke volume (SV), at 1, 6, and 24 hours from admission. The decision to give fluid in these children was thereby based on the presence of at least one sign of inadequate tissue perfusion. SV was reassessed directly after administration of a fluid bolus of 10 mL/kg over 10 minutes. Fluid responsiveness was considered adequate when there was ≥ 10% increase in SV after fluid bolus. Minimal IVC diameter indexed to body surface area and its distensibility index can be predictors of fluid responsiveness at all times: 1 hour (area under curve [AUC] = 0.88; 95% confidence interval [CI] = 0.77–0.96), 6 hours (AUC = 0.86; 95% CI = 0.67–0.97), and 24 hours (AUC = 0.77; 95% CI = 0.6–0.95). IVC distensibility index can also predict fluid responsiveness at 1 hour (AUC= 0.87; 95% CI = 0.74–0.95), 6 hours (AUC = 0.86; 95% CI = 0.73–0.94), and 24 hours (AUC = 1; 95% CI = 0.77–1). The cutoff points of each parameter differed from time to time (contradicts with previous statement that says it is predictor at all times). The maximum IVC diameter could not predict fluid responsiveness at any time from admission. Minimal IVC diameter and its distensibility index were feasible noninvasive surrogates of fluid responsiveness in pediatric septic shock at different times from admission.

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Safe ECMO femoral decannulation by placement of inferior vena cava filter via internal jugular vein

Journal of Artificial Organs ◽

10.1007/s10047-016-0892-y ◽

2016 ◽

Vol 19 (3) ◽

pp. 297-300 ◽

Cited By ~ 2

Author(s):

Luigi Castagna ◽

Elena Maggioni ◽

Anna Coppo ◽

Barbara Cortinovis ◽

Veronica Meroni ◽

...

Keyword(s):

Inferior Vena Cava ◽

Internal Jugular Vein ◽

Inferior Vena Cava Filter ◽

Inferior Vena ◽

Jugular Vein ◽

Vena Cava ◽

Vena Cava Filter

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Respiratory variation of inferior vena cava diameter and central venous pressure in ventilated and non-ventilated children in fluid refractory septic shock: an observational study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193691 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1947

Author(s):

Mohd Kashif Ali ◽

Eeman Naim

Keyword(s):

Septic Shock ◽

Inferior Vena Cava ◽

Central Venous Pressure ◽

Inferior Vena ◽

Venous Pressure ◽

Vena Cava ◽

Central Venous ◽

Mechanically Ventilated ◽

Spontaneously Breathing ◽

Ventilated Patients

Background: Ultrasound guided fluid assessment in management of septic shock has come up as an adjunct to the current gold standard Central Venous Pressure monitoring. This study was designed to observe the respiro-phasic variation of IVC diameter (RV-IVCD) in invasively mechanically ventilated and spontaneously breathing paediatric patients of fluid refractory septic shock.Methods: This was a prospective observational study done at Paediatric intensive Care Unit (PICU) in Paediatric ward of Jawaharlal Nehru Medical College and Hospital (JNMCH) from February 2016 to June 2017. 107 consecutive patients between 1 year to 16 years age who were in shock despite 40ml/kg of fluid administration were included. Inferior Vena Cava (IVC) diameters were measured at end-expiration and end inspiration and the IVC collapsibility index was calculated. Simultaneously Central Venous Pressure (CVP) was recorded. Both values were obtained in ventilated and non-ventilated patients. Data was analysed to determine to look for the profile of RV-IVCD and CVP in ventilated and non-ventilated cases.Results: Out of 107 patients, 91 were on invasive mechanical ventilation and 16 patients were spontaneously breathing. There was a strong negative correlation between central venous pressure (CVP) and inferior vena cava collapsibility (RV-IVCD) in both spontaneously breathing (-0.810) and mechanically ventilated patients (-0.700). Negative correlation was significant in both study groups in CVP <8 mmHg and only in spontaneously breathing patients in CVP 8-12 mmHg range. IVC collapsibility showed a decreasing trend with rising CVP in both spontaneously breathing and mechanically ventilated patients.Conclusion: Ultrasonography guided IVCCI appears to be a valuable index in assessing fluid status in both spontaneously breathing and mechanically ventilated septic shock patients. However, more data is required from the paediatric population so as to define it as standard of practice.

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