Ultrasound-guided estimation of internal jugular vein collapsibility index in patients with shock in emergency department

Abstract

OBJECTIVE: 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.

METHODS: 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.

RESULTS: 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 (r = −0.541, P = 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 (r = −0.453, P = 0.001). Similarly, the correlation between IJV CI (AP diameter) and CVP, followed (r = −0.412, P = 0.008) was statistically significant.

CONCLUSION: 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.

How to cite this article: Chawang HJ, Kaeley N, Bhushan BB, Chauhan U, Baid H, Asokan R, et al. Ultrasound-guided estimation of internal jugular vein collapsibility index in patients with shock in emergency department. Turk J Emerg Med 2022;22:206-12.

Ethical approval was provided by the All India Institute of medical sciences (Rishikesh) Institutional Ethics Committee on 29‑11‑2019 in the letter AIIMS/IEC/19/1208.

A written consent was taken from every patient/next of kin in a language they understand (English or Hindi) before the start of the study.

Dr HC – contributed to conceptualization, data curation, formal analysis, investigation, methodology, resources, software, validation, writing original draft and writing review/editing
Dr NK – contributed to conceptualization, formal analysis, investigation, methodology, supervision, validation, writing original draft, and writing review/editing
Dr BB – contributed formal analysis, investigation, methodology, supervision resources, validation, writing original draft, and writing review/editing
Dr UC – contributed formal analysis, investigation, methodology, resources, validation, writing original draft and writing review/editing
Dr HB – contributed to data curation, formal analysis, investigation, resources, software, validation
Dr RA ‑ contributed to data curation, formal analysis, investigation, resources, software, validation
Dr SG – contributed to data curation, formal analysis, investigation, resources, software, validation
All authors have approved the submitted version and have agreed both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

None declared.

None.