Kasem Samaa A, Ahmed Ahmed Goda, Nagm Eldeen Hebattallah, Kassim Dina Y
Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Anesth Pain Med. 2021 Jul 12;11(3):e114597. doi: 10.5812/aapm.114597. eCollection 2021 Jun.
This study aimed to assess the correlation between the internal jugular vein/common carotid artery (IJV/CCA) cross-sectional area (CSA) ratio and the inferior vena cava (IVC) diameter as non-invasive techniques for the assessment of intravascular volume.
The study samples included 35 adult patients of both sexes (age range: 20 - 60 years) according to the criteria of the American Society of Anaesthesiology (ASA) physical status II - III, who were admitted to the surgical intensive care unit (SICU) after major surgeries for the assessment of intravascular volume status.
There was a positive correlation between the IJV/CCA CSA ratio and the IVC maximum and minimum diameter before and after fluid infusion (r = 0.923, P < 0.001 and r = 0.390, P = 0.021, respectively) and between the IJV/CCA CSA ratio at inspiration and the IVC minimum diameter before and after fluid infusion (r = 0.605, P < 0.001 and r = 0.496, P < 0.001, respectively). The sensitivity and specificity analysis of the IJV/CCA CSA during inspiration after fluid correction to predict a central venous pressure (CVP) of 8 - 12 cmHO showed that at a ratio of 2.56, the highest sensitivity was 56.5%, and the specificity was 83.3%; at a ratio of 2.58, the highest sensitivity was 65.2% and the specificity was 75%. During expiration, at a ratio of 2.62, the highest sensitivity was 52.2%, and the specificity was 67%; and at a ratio of 2.65, the sensitivity was 56.5%, and the specificity was 50%.
The assessment of the IJV/CCA CSA ratio using bedside ultrasound could be a non-invasive tool for the evaluation of intravascular volume status in spontaneously breathing adult patients after major surgeries.
本研究旨在评估颈内静脉/颈总动脉（IJV/CCA）横截面积（CSA）比值与下腔静脉（IVC）直径之间的相关性，将其作为评估血管内容量的非侵入性技术。
根据美国麻醉医师协会（ASA）身体状况II - III标准，研究样本包括35名成年男女患者（年龄范围：20 - 60岁），这些患者在接受大手术后被收入外科重症监护病房（SICU）以评估血管内容量状态。
输液前后IJV/CCA CSA比值与IVC最大和最小直径之间存在正相关（分别为r = 0.923，P < 0.001和r = 0.390，P = 0.021），吸气时IJV/CCA CSA比值与输液前后IVC最小直径之间也存在正相关（分别为r = 0.605，P < 0.001和r = 0.496，P < 0.001）。液体纠正后吸气时IJV/CCA CSA预测中心静脉压（CVP）为8 - 12 cmH₂O的敏感性和特异性分析表明，比值为2.56时，最高敏感性为56.5%，特异性为83.3%；比值为2.58时，最高敏感性为65.2%，特异性为75%。呼气时，比值为2.62时，最高敏感性为52.2%，特异性为67%；比值为2.65时，敏感性为56.5%，特异性为50%。
使用床旁超声评估IJV/CCA CSA比值可能是评估大手术后自主呼吸成年患者血管内容量状态的一种非侵入性工具。
