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

Year 2021, , 241 - 246, 15.06.2021

Yunus Emre Özlüer , Mücahit Kapçı

https://doi.org/10.17343/sdutfd.732202

Cited By: 1

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.

Keywords

Santral venöz basınç, İnternal juguler ven, Kollapsibilite İndeksi, Vena cava inferior, Ultrason, Korelasyon

Supporting Institution

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Project Number

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Thanks

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

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.

Keywords

Central venous pressure, Internal jugular vein, Collapsibility index, Vena cava inferior, Ultrasound, Correlation

Project Number

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