重症患者颈内静脉与下腔静脉塌陷指数与直接中心静脉压测量的相关性：一项观察性研究

Correlation of Internal Jugular Vein and Inferior Vena Cava Collapsibility Index with Direct Central Venous Pressure Measurement in Critically-ill Patients: An Observational Study.

作者信息

Kumar Anuj, Bharti Alok K, Hussain Mumtaz, Kumar Sanjeev, Kumar Arvind

机构信息

Department of Anesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

Department of Anesthesiology and Critical Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

出版信息

Indian J Crit Care Med. 2024 Jun;28(6):595-600. doi: 10.5005/jp-journals-10071-24741.

DOI:10.5005/jp-journals-10071-24741

PMID:39130396

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11310668/

Abstract

BACKGROUND AND AIMS

Prompt assessments and quick replacement of intravascular fluid are critical steps to resuscitate hypovolemic patients. Intravascular volume assessment by direct central venous pressure (CVP) measurement is an invasive, time-consuming, and labor-intensive procedure. Nowadays, bedside ultrasound-guided volume assessment of the internal jugular vein (IJV) or inferior vena cava (IVC) is commonly employed as a proxy for direct CVP.Therefore, we examined the strength of association between CVP and collapsibility index (CI) of the IJV and IVC for evaluating the volume status of critically ill patients.

METHODS

Bedside USG-guided A-P diameter and cross-sectional area of the right IJV and IVC were measured, and their corresponding collapsibility indices were deduced. The results of the IJV and IVC indices were correlated with CVP.

RESULTS

About 60 out of 70 enrolled patients were analyzed. The baseline clinical parameters of patients are shown in Table 1. For CSA and AP diameter, the correlations between CVP and IJV-CI at 0° were = -0.107 ( = 0.001) and = -0.092 ( = 0.001). Correlations between CVP and IJV-CI at 30° for CSA and diameter, however, were ( = -0.109, = 0.001) and ( = -0.117, = 0.001), respectively. Table 2 depicts the correlation between CVP and IVC-CI = -0.503, = 0.001 for CSA and = -0.452, = 0.001 for diameter.

CONCLUSION

The IVC and IJV collapsibility indices can be used in place of invasive CVP monitoring to assess fluid status in critically ill patients.

HOW TO CITE THIS ARTICLE

Kumar A, Bharti AK, Hussain M, Kumar S, Kumar A. Correlation of Internal Jugular Vein and Inferior Vena Cava Collapsibility Index with Direct Central Venous Pressure Measurement in Critically-ill Patients: An Observational Study. Indian J Crit Care Med 2024;28(6):595-600.

摘要

背景与目的

及时评估并快速补充血管内液体是低血容量患者复苏的关键步骤。通过直接测量中心静脉压（CVP）来评估血管内容量是一种侵入性、耗时且劳动强度大的操作。如今，床旁超声引导下对颈内静脉（IJV）或下腔静脉（IVC）进行容量评估通常被用作直接测量CVP的替代方法。因此，我们研究了CVP与IJV和IVC的塌陷指数（CI）之间的关联强度，以评估危重症患者的容量状态。

方法

在床旁超声引导下测量右侧IJV和IVC的前后径及横截面积，并推导出它们相应的塌陷指数。IJV和IVC指数的结果与CVP进行相关性分析。

结果

对纳入研究的70例患者中的约60例进行了分析。患者的基线临床参数见表1。对于横截面积（CSA）和前后径，CVP与0°时IJV - CI的相关性分别为r = -0.107（p = 0.001）和r = -0.092（p = 0.001）。然而，对于CSA和前后径，CVP与30°时IJV - CI的相关性分别为（r = -0.109，p = 0.001）和（r = -0.117，p = 0.001）。表2显示了CVP与IVC - CI的相关性，CSA时r = -0.503，p = 0.001，前后径时r = -0.452，p = 0.001。