Chawang Hannah Joyke, Kaeley Nidhi, Bhardwaj Bharat Bhushan, Chauhan Udit, Baid Himanshi, Asokan Reshma, Galagali Santosh Sadashiv
Department of Emergency Medicine All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Radiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Turk J Emerg Med. 2022 Sep 30;22(4):206-212. doi: 10.4103/2452-2473.357352. eCollection 2022 Oct-Dec.
To correlate ultrasound-guided estimation of Internal Jugular Vein Collapsibility Index (IJV-CI) with inferior vena cava CI (IVC-CI) and invasively monitored central venous pressure (CVP) in patients with shock in the emergency medicine department.
A prospective observational study was done in the emergency department (ED). The study was conducted over 15 months (November 2019 to April 2021). It included patients more than 18 years presenting to the ED in shock. The IJV and IVC diameter and cross-sectional area were measured using ultrasound. The corresponding collapsibility indexes were then calculated and correlated with the invasively monitored CVP of the patient. Data were then analyzed using the Statistical Package for the Social Science (SPSS): Version 23 for windows. Pearson's correlation was used between CVP and collapsibility indexes.
The mean (±standard deviation) age of the patients was 49.01 (±15.6). There was a 47 (64%) male predominance which outnumbered females 26 (36%). The correlation coefficient was statistically significant between CVP and the collapsibility indices for various IJV and IVC parameters. The highest correlation ( = -0.541, = 0.005) was seen between IVC-CI (CI 5) and CVP. This was followed by a correlation seen at a 30° position for IJV CI (cross-sectional area) with CVP ( = -0.453, = 0.001). Similarly, the correlation between IJV CI (AP diameter) and CVP, followed ( = -0.412, = 0.008) was statistically significant.
Both IJV and IVC collapsibility indices correlated significantly with invasively measured CVP. Hence, they present as an effective tool in fluid resuscitation in patients with shock in ED.
在急诊科休克患者中，将超声引导下颈内静脉塌陷指数（IJV-CI）与下腔静脉塌陷指数（IVC-CI）以及有创监测的中心静脉压（CVP）进行相关性分析。
在急诊科进行一项前瞻性观察性研究。该研究历时15个月（2019年11月至2021年4月）。纳入年龄超过18岁、因休克就诊于急诊科的患者。使用超声测量颈内静脉和下腔静脉的直径及横截面积。然后计算相应的塌陷指数，并与患者有创监测的中心静脉压进行相关性分析。随后使用社会科学统计软件包（SPSS）Windows版23对数据进行分析。中心静脉压与塌陷指数之间采用Pearson相关性分析。
患者的平均（±标准差）年龄为49.01（±15.6）岁。男性占优势，有47例（64%），女性26例（36%）。不同颈内静脉和下腔静脉参数的中心静脉压与塌陷指数之间的相关系数具有统计学意义。下腔静脉塌陷指数（CI 5）与中心静脉压之间的相关性最高（r = -0.541，P = 0.005）。其次是颈内静脉塌陷指数（横截面积）在30°位置与中心静脉压的相关性（r = -0.453，P = 0.001）。同样，颈内静脉塌陷指数（前后径）与中心静脉压之间的相关性（r = -0.412，P = 0.008）也具有统计学意义。
颈内静脉和下腔静脉塌陷指数均与有创测量的中心静脉压显著相关。因此，它们是急诊科休克患者液体复苏的有效工具。
