Research Article
BibTex RIS Cite

NONİNVAZİV SANTRAL VENÖZ BASINÇ ÖLÇÜMÜ YÖNTEMLERİNİN KIYASLANMASI: İNTERNAL JUGULER VEN VE VENA CAVA İNFERİOR

Year 2021, Volume: 28 Issue: 2, 241 - 246, 15.06.2021
https://doi.org/10.17343/sdutfd.732202

Abstract

Amaç
Santral venöz basınç ölçümü hastaların hacim durumunu
tespit etmek için etkili bir yöntemdir. Bununla
birlikte, pnömotoraks gibi hayatı tehdit eden komplikasyonlar
ortaya çıkabilir. Ultrasonografik ölçümlerin
invaziv santral venöz basıncın bir göstergesi olarak
kullanılabileceğini düşünmekteyiz.
Gereç ve Yöntem
Çalışmamız, Ocak 2015-Ocak 2016 tarihleri arasında,
18 yaşın üzerinde olan ve Acil Yoğun Bakım Ünitemizde
internal juguler vene (IJV) santral venöz kateter
yerleştirilen 81 hasta üzerinde gerçekleştirildi. İnternal
juguler vendeki kanın yüksekliği, internal juguler ven
kollapsibilite indeksi (IJV-Kİ) ve kaval indeks (Kİ) ultrasonografi
ile ölçüldü. Daha sonra invaziv santral venöz
basınç (SVB) ölçüldü ve hastalar düşük SVB ve
normal SVB grupları olarak iki gruba ayrıldı ve bu üç
yöntem açısından gruplar arasında istatistiksel olarak
anlamlılık arandı.
Bulgular
Yaş ortalaması 68,58 ± 13,33 idi. Hastaların 54'ü (%
66,6) erkekti. Kırk altı hasta (% 56,8) mekanik ventilasyon
altındaydı. Düşük SVB grubu 62 hastadan (%
76,5) oluştu. Ortalama invaziv SVB 4,83 ± 4,26 mmHg
idi. IJV-Kİ ve invaziv SVB ile Kİ (r= 0,267, p=0,016 ve
r=0,319, p=0,04), IJV yükseklik yöntemi ve Kİ ile invaziv
SVB ölçümü arasında anlamlı korelasyonlar vardı
(r=-0,231, p=0,03 ve r=0,357, p=0,01). Kİ ile invaziv
SVB ölçümü arasında herhangi bir korelasyon izlenmedi
(r = -0,010, p = 0,368).
Sonuç
Noninvaziv santral venöz basınç ölçüm yöntemleri invaziv
santral venöz basınç düzeyleri için bir gösterge
olarak kullanılabilir. IJV-Kİ, SVB'ı tahmin etmek için
yararlı bir araç olabilir. IJV ölçümleri, özellikle hipovolemik
hastalarda vena cava inferior ölçümlerinden
daha iyi sonuç vermektedir.

Supporting Institution

yok

Project Number

yok

Thanks

yok

References

  • References 1. Lewis T. Early signs of cardiac failure of the congestive type. BMJ 1930;1:849-52.
  • 2. Eisenberg PR, Jaffe AS, Schuster DP. Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients. Crit Care Med 1984;12:549-53.
  • 3. Barbosa-Hernandez G. Echo IV. In: TD Raj. Data interpretation in anesthesia: A clinical guide (1st Ed), Midwest, Springer, 2017;311-6.
  • 4. Saugel B, Scheeren TWL, Teboul J. Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit Care 2017;21:225.
  • 5. Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization. Cochrane Database of Systematic Reviews 2015;1: CD006962.
  • 6. Haliloğlu M, Bilgili B, Kararmaz A, Cinel İ. The value of internal jugular vein collapsibility index in sepsis. Ulus Travma Acil Cerrahi Derg 2017;23(4):294–300. 7. Parikh R, Spring M, Weinberg J, Reardon CC, Farber HW. Use of ultrasound-measured internal jugular vein collapsibility index to determine static intracardiac pressures in patients with presumed pulmonary hypertension. Ann Intensive Care 2019;9:124.
  • 8. Pourmand A, Pyle M, Ymane D, Sumon K, Frasure SE. The utility of point-of-care ultrasound in the assessment of the volume status in acute and critically ill patients. World J Emerg Med 2019;10(4):232-38.
  • 9. Ünlüer EE, Kara PH. Ultrasonography of jugular vein as a marker of hypovolemia in healthy volunteers. Am J Emerg Med 2013;31:173-7.
  • 10. Nik Muhamad NA, Safferi RS, Robertson CE. Internal jugular vein height and inferior vena cava diameter measurement using ultrasound to determine central venous pressure: a correlation study. Med J Malaysia 2015;70(2):63–6.
  • 11. Nagdev AD, Merchant RC, Tirado-Gonzalez A, Sisson CA, Murphy MC. Emergency department bedside ultrasonographic measurement of the caval index for noninvasive determination of low central venous pressure. Ann Emerg Med 2010;55(3):290-5.
  • 12. Orso D, Guglielmo N, Federici N, Cugini F, Ban A, Mearelli F, et al. Accuracy of the caval index and the expiratory diameter of the inferior vena cava for the diagnosis of the dehydration in elderly. J Ultrasound 2016;19:203-9.
  • 13. Aydin SA, Ozdemir F, Taskin G, Ocakoglu G, Yıldırım H, Koksal O. Is there a relationship between the diameter of the inferior vena cava and hemodynamic parameters in critically ill patients? Niger J Clin Pract 2015;18:810-3.
  • 14. Govender J, Postma I, Wood D, Sibanda W. Is there an association between central venous pressure measurement and ultrasound assessment of the inferior vena cava? Afr J Emerg Med 2018;8(3):106–9.
  • 15. Kent A, Patil P, Davila V, Bailey JK, Jones C, Evans DC, et al. Sonographic evaluation of the volume status: Can internal jugular or femoral vein collapsibility be used in the absence of IVC visualization? Ann Thoracic Med 2015;10(1):44-9.

COMPARISON OF NONINVASIVE CENTRAL VENOUS PRESSURE MEASUREMENT METHODS: INTERNAL JUGULAR VEIN VERSUS VENA CAVA INFERIOR

Year 2021, Volume: 28 Issue: 2, 241 - 246, 15.06.2021
https://doi.org/10.17343/sdutfd.732202

Abstract

Objective
Central venous pressure measurement is an effective
method to detect the volume status of the patients.
However, life-threatening complications such as
pneumothorax may occur. We assume that ultrasonographic
measurements may be used as a surrogate
of invasive central venous pressure.
Materials and Methods
Our study has been conducted between January
2015-January 2016 on 81 patients who were over
the age of 18 and to whom a central venous catheter
has been placed in the internal jugular vein (IJV)
in our Emergency Intensive Care Unit. The height of
the blood column in the internal jugular vein, internal
jugular vein collapsibility index (IJV-CI) and the caval
index (CI) of vena cava inferior have been measured
by ultrasound. Then, invasive central venous pressure
(CVP) has been measured and the patients were
separated into two groups as low CVP and normal
CVP groups and statistically significance was sought
between groups in regard of these three methods.
Results
The mean age was 68.58±13.33 years. Fifty-four of
the patients (66.6%) were male. Forty-six patients
(56.8%) were mechanically ventilated. Low CVP
group consisted of 62 patients (76.5%). Mean invasive
CVP was 4.83±4.26 mmHg. There were significant
correlations between IJV-CI and invasive CVP along
with the CI (r=-0.267, p=0.016 and r=0.319, p=0.04,
respectively), IJV height method and CI as well as
invasive CVP measurement (r=-0.231, p=0.03 and
r=0.357, p=0.01, respectively). The CI did not yield
any correlation between invasive CVP measurement
(r=-0.010, p=0.368).
Conclusion
Noninvasive central venous pressure measurement
methods may be used as a surrogate for invasive
central venous pressure levels. The IJV-CI may be
a useful tool to estimate CVP. Measurements of IJV
yields better results than the measurements from
vena cava inferior (VCI) especially in volume depleted
patients.

Project Number

yok

References

  • References 1. Lewis T. Early signs of cardiac failure of the congestive type. BMJ 1930;1:849-52.
  • 2. Eisenberg PR, Jaffe AS, Schuster DP. Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients. Crit Care Med 1984;12:549-53.
  • 3. Barbosa-Hernandez G. Echo IV. In: TD Raj. Data interpretation in anesthesia: A clinical guide (1st Ed), Midwest, Springer, 2017;311-6.
  • 4. Saugel B, Scheeren TWL, Teboul J. Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit Care 2017;21:225.
  • 5. Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization. Cochrane Database of Systematic Reviews 2015;1: CD006962.
  • 6. Haliloğlu M, Bilgili B, Kararmaz A, Cinel İ. The value of internal jugular vein collapsibility index in sepsis. Ulus Travma Acil Cerrahi Derg 2017;23(4):294–300. 7. Parikh R, Spring M, Weinberg J, Reardon CC, Farber HW. Use of ultrasound-measured internal jugular vein collapsibility index to determine static intracardiac pressures in patients with presumed pulmonary hypertension. Ann Intensive Care 2019;9:124.
  • 8. Pourmand A, Pyle M, Ymane D, Sumon K, Frasure SE. The utility of point-of-care ultrasound in the assessment of the volume status in acute and critically ill patients. World J Emerg Med 2019;10(4):232-38.
  • 9. Ünlüer EE, Kara PH. Ultrasonography of jugular vein as a marker of hypovolemia in healthy volunteers. Am J Emerg Med 2013;31:173-7.
  • 10. Nik Muhamad NA, Safferi RS, Robertson CE. Internal jugular vein height and inferior vena cava diameter measurement using ultrasound to determine central venous pressure: a correlation study. Med J Malaysia 2015;70(2):63–6.
  • 11. Nagdev AD, Merchant RC, Tirado-Gonzalez A, Sisson CA, Murphy MC. Emergency department bedside ultrasonographic measurement of the caval index for noninvasive determination of low central venous pressure. Ann Emerg Med 2010;55(3):290-5.
  • 12. Orso D, Guglielmo N, Federici N, Cugini F, Ban A, Mearelli F, et al. Accuracy of the caval index and the expiratory diameter of the inferior vena cava for the diagnosis of the dehydration in elderly. J Ultrasound 2016;19:203-9.
  • 13. Aydin SA, Ozdemir F, Taskin G, Ocakoglu G, Yıldırım H, Koksal O. Is there a relationship between the diameter of the inferior vena cava and hemodynamic parameters in critically ill patients? Niger J Clin Pract 2015;18:810-3.
  • 14. Govender J, Postma I, Wood D, Sibanda W. Is there an association between central venous pressure measurement and ultrasound assessment of the inferior vena cava? Afr J Emerg Med 2018;8(3):106–9.
  • 15. Kent A, Patil P, Davila V, Bailey JK, Jones C, Evans DC, et al. Sonographic evaluation of the volume status: Can internal jugular or femoral vein collapsibility be used in the absence of IVC visualization? Ann Thoracic Med 2015;10(1):44-9.
There are 14 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Yunus Emre Özlüer 0000-0001-8297-7525

Mücahit Kapçı 0000-0002-6191-7336

Project Number yok
Publication Date June 15, 2021
Submission Date May 5, 2020
Acceptance Date July 1, 2020
Published in Issue Year 2021 Volume: 28 Issue: 2

Cite

Vancouver Özlüer YE, Kapçı M. COMPARISON OF NONINVASIVE CENTRAL VENOUS PRESSURE MEASUREMENT METHODS: INTERNAL JUGULAR VEIN VERSUS VENA CAVA INFERIOR. Med J SDU. 2021;28(2):241-6.

                                                                                               14791 


Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.