Skip to main content
Top
Published in: Indian Journal of Surgery 1/2023

Open Access 23-04-2022 | Ultrasound | Original Article

Correlation Between Ultrasound-Measured Diameter and Blood Flow Velocity of the Internal Jugular Veins with the Preoperative Blood Volume in Elderly Patients

Authors: Wei Wang, Qingqing Liu, Zhijian Lan, Xiaohong Wen

Published in: Indian Journal of Surgery | Special Issue 1/2023

Login to get access

Abstract

The study aimed to explore the correlation of the diameter and blood flow velocity of the internal jugular vein with the preoperative blood volume in elderly patients and to providence for rapid evaluation of preoperative blood volume with ultrasound in elderly patients. Thirty patients over 65 years old were recruited in the study. Patient’s central venous pressure (CVP) was recorded before anesthesia. The maximum diameter (Dmax) and the minimum diameter (Dmin) of the left internal jugular vein were measured by M type ultrasound and the respiratory variation index (RVI), defined as (Dmax − Dmin) / Dmax × 100%, was calculated. The maximum blood flow velocity (BVmax) and the minimum blood flow velocity (BVmin) were measured by Doppler ultrasound, and the blood flow variation index (BVI), defined as (BVmax − BVmin) / BVmax × 100%, was calculated. Then, each of the patients was given with 5 ml/kg crystalloid solution, and the relevant data were measured again and compared to that before infusion. The correlation between each measurement index and CVP, and their efficiency in predicting CVP > 6 mmHg were statistically evaluated. No matter before or after infusion, Dmax, Dmin, BVmax, and BVmin were positively correlated with CVP (Correlation is significant at the 0.01 level (2-tailed)); and RVI was negatively correlated with CVP (Correlation is significant at the 0.01 level (2-tailed)); however, BVI is negatively correlated with the CVP with no statistically significant difference. Through the analysis of ROC curve, Dmax, Dmin, RVI, BVmax, and BVmin could be used to predict the CVP > 6 mmHg in these patients, and the best index was BVmax; BVI diagnosis was not effective. Ultrasonic measurements of internal jugular vein diameter, respiratory variability, and blood flow velocity were correlated with preoperative CVP in elderly patients, indicating that these indexes could potentially be used to evaluate the preoperative blood volume in elderly patients.
Literature
1.
go back to reference Boller E, Boller M (2015) Assessment of fluid balance and the approach to fluid therapy in the perioperative patient. Vet Clin North Am Small Anim Pract 45(5):895–915CrossRefPubMed Boller E, Boller M (2015) Assessment of fluid balance and the approach to fluid therapy in the perioperative patient. Vet Clin North Am Small Anim Pract 45(5):895–915CrossRefPubMed
2.
go back to reference Finfer S, Myburgh J, Bellomo R (2018) Intravenous fluid therapy in critically ill adults. Nat Rev Nephrol 14(9):541–557CrossRefPubMed Finfer S, Myburgh J, Bellomo R (2018) Intravenous fluid therapy in critically ill adults. Nat Rev Nephrol 14(9):541–557CrossRefPubMed
3.
go back to reference Hoste EA, Maitland K, Brudney CS, Mehta R, Vincent JL, Yates D et al (2014) Four phases of intravenous fluid therapy: a conceptual model. Br J Anaesth 113(5):740–747CrossRefPubMed Hoste EA, Maitland K, Brudney CS, Mehta R, Vincent JL, Yates D et al (2014) Four phases of intravenous fluid therapy: a conceptual model. Br J Anaesth 113(5):740–747CrossRefPubMed
4.
go back to reference Myles PS, Andrews S, Nicholson J, Lobo DN, Mythen M (2017) Contemporary approaches to perioperative IV fluid therapy. World J Surg 41(10):2457–2463CrossRefPubMed Myles PS, Andrews S, Nicholson J, Lobo DN, Mythen M (2017) Contemporary approaches to perioperative IV fluid therapy. World J Surg 41(10):2457–2463CrossRefPubMed
5.
go back to reference Sulzer JK, Sastry AV, Meyer LM, Cochran A, Buhrman WC, Baker EH et al (2018) The impact of intraoperative goal-directed fluid therapy on complications after pancreaticoduodenectomy. Ann Med Surg (Lond) 36:23–28CrossRefPubMed Sulzer JK, Sastry AV, Meyer LM, Cochran A, Buhrman WC, Baker EH et al (2018) The impact of intraoperative goal-directed fluid therapy on complications after pancreaticoduodenectomy. Ann Med Surg (Lond) 36:23–28CrossRefPubMed
6.
go back to reference Cesur S, Çardaközü T, Kuş A, Türkyılmaz N, Yavuz Ö (2019) Comparison of conventional fluid management with PVI-based goal-directed fluid management in elective colorectal surgery. J Clin Monit Comput 33(2):249–257CrossRefPubMed Cesur S, Çardaközü T, Kuş A, Türkyılmaz N, Yavuz Ö (2019) Comparison of conventional fluid management with PVI-based goal-directed fluid management in elective colorectal surgery. J Clin Monit Comput 33(2):249–257CrossRefPubMed
7.
go back to reference Suehiro K, Tanaka K, Matsuura T, Funao T, Yamada T, Mori T et al (2014) The Vigileo-FloTrac™ system: arterial waveform analysis for measuring cardiac output and predicting fluid responsiveness: a clinical review. J Cardiothorac Vasc Anesth 28(5):1361–1374CrossRefPubMed Suehiro K, Tanaka K, Matsuura T, Funao T, Yamada T, Mori T et al (2014) The Vigileo-FloTrac™ system: arterial waveform analysis for measuring cardiac output and predicting fluid responsiveness: a clinical review. J Cardiothorac Vasc Anesth 28(5):1361–1374CrossRefPubMed
8.
go back to reference Tousignant CP, Walsh F, Mazer CD (2000) The use of transesophageal echocardiography for preload assessment in critically ill patients. Anesth Analg 90(2):351–355CrossRefPubMed Tousignant CP, Walsh F, Mazer CD (2000) The use of transesophageal echocardiography for preload assessment in critically ill patients. Anesth Analg 90(2):351–355CrossRefPubMed
9.
go back to reference Vignon P (2004) Evaluation of fluid responsiveness in ventilated septic patients: back to venous return. Intensive Care Med 30(9):1699–1701CrossRefPubMed Vignon P (2004) Evaluation of fluid responsiveness in ventilated septic patients: back to venous return. Intensive Care Med 30(9):1699–1701CrossRefPubMed
10.
go back to reference Ezegbe BN, Eseadi C, Ede MO, Igbo JN, Anyanwu JI, Ede KR et al (2019) Impacts of cognitive-behavioral intervention on anxiety and depression among social science education students: a randomized controlled trial. Medicine (Baltimore) 98(15):e14935CrossRefPubMed Ezegbe BN, Eseadi C, Ede MO, Igbo JN, Anyanwu JI, Ede KR et al (2019) Impacts of cognitive-behavioral intervention on anxiety and depression among social science education students: a randomized controlled trial. Medicine (Baltimore) 98(15):e14935CrossRefPubMed
11.
go back to reference Liu J, Deng X (2014) 2014 Chinese anesthesiology guidelines and expert consensus. Beijing, People’s Health Publishing House, p 201–202 Liu J, Deng X (2014) 2014 Chinese anesthesiology guidelines and expert consensus. Beijing, People’s Health Publishing House, p 201–202
12.
go back to reference Lou X, Lu G, Zhao M, Jin P (2018) Preoperative fluid management in traumatic shock: a retrospective study for identifying optimal therapy of fluid resuscitation foraged patients. Medicine (Baltimore) 97(8):e9966CrossRefPubMed Lou X, Lu G, Zhao M, Jin P (2018) Preoperative fluid management in traumatic shock: a retrospective study for identifying optimal therapy of fluid resuscitation foraged patients. Medicine (Baltimore) 97(8):e9966CrossRefPubMed
13.
go back to reference Feissel M, Michard F, Faller JP, Teboul JL (2004) The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Intensive Care Med 30(9):1834–1837CrossRefPubMed Feissel M, Michard F, Faller JP, Teboul JL (2004) The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Intensive Care Med 30(9):1834–1837CrossRefPubMed
14.
go back to reference Zhang Z, Xu X, Ye S, Xu L (2014) Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound Med Biol 40(5):845–853CrossRefPubMed Zhang Z, Xu X, Ye S, Xu L (2014) Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound Med Biol 40(5):845–853CrossRefPubMed
15.
go back to reference Haliloğlu M, Bilgili B, Kararmaz A, Cinel İ (2017) The value of internal jugular vein collapsibility index in sepsis. Ulus Travma Acil Cerrahi Derg 23(4):294–300PubMed Haliloğlu M, Bilgili B, Kararmaz A, Cinel İ (2017) The value of internal jugular vein collapsibility index in sepsis. Ulus Travma Acil Cerrahi Derg 23(4):294–300PubMed
16.
go back to reference Jang T, Aubin C, Naunheim R, Char D (2004) Ultrasonography of the internal jugular vein in patients with dyspnea without jugular venous distention on physical examination. Ann Emerg Med 44(2):160–168CrossRefPubMed Jang T, Aubin C, Naunheim R, Char D (2004) Ultrasonography of the internal jugular vein in patients with dyspnea without jugular venous distention on physical examination. Ann Emerg Med 44(2):160–168CrossRefPubMed
17.
go back to reference Achar SK, Sagar MS, Shetty R, Kini G, Samanth J, Nayak C et al (2016) Respiratory variation in aortic flow peak velocity and inferior vena cava distensibility as indices of fluid responsiveness in anaesthetised and mechanically ventilated children. Indian J Anaesth 60(2):121–126CrossRefPubMedPubMedCentral Achar SK, Sagar MS, Shetty R, Kini G, Samanth J, Nayak C et al (2016) Respiratory variation in aortic flow peak velocity and inferior vena cava distensibility as indices of fluid responsiveness in anaesthetised and mechanically ventilated children. Indian J Anaesth 60(2):121–126CrossRefPubMedPubMedCentral
18.
go back to reference Iwamoto Y, Tamai A, Kohno K, Masutani S, Okada N, Senzaki H (2011) Usefulness of respiratory variation of inferior vena cava diameter for estimation of elevated central venous pressure in children with cardiovascular disease. Circ J 75(5):1209–1214CrossRefPubMed Iwamoto Y, Tamai A, Kohno K, Masutani S, Okada N, Senzaki H (2011) Usefulness of respiratory variation of inferior vena cava diameter for estimation of elevated central venous pressure in children with cardiovascular disease. Circ J 75(5):1209–1214CrossRefPubMed
19.
go back to reference Lipton B (2000) Estimation of central venous pressure by ultrasound of the internal jugular vein. Am J Emerg Med 18(4):432–434CrossRefPubMed Lipton B (2000) Estimation of central venous pressure by ultrasound of the internal jugular vein. Am J Emerg Med 18(4):432–434CrossRefPubMed
20.
go back to reference Magder S (2015) Understanding central venous pressure: not a preload index? Curr Opin Crit Care 21(5):369–375CrossRefPubMed Magder S (2015) Understanding central venous pressure: not a preload index? Curr Opin Crit Care 21(5):369–375CrossRefPubMed
21.
go back to reference Marik PE, Cavallazzi R (2013) Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Crit Care Med 41(7):1774–1781CrossRefPubMed Marik PE, Cavallazzi R (2013) Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Crit Care Med 41(7):1774–1781CrossRefPubMed
22.
go back to reference Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM et al (2013) Surviving sepsis campaign guidelines committee including the pediatric subgroup. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 39(2):165–228CrossRefPubMedPubMedCentral Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM et al (2013) Surviving sepsis campaign guidelines committee including the pediatric subgroup. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 39(2):165–228CrossRefPubMedPubMedCentral
23.
go back to reference Dipti A, Soucy Z, Surana A, Chandra S (2012) Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. Am J Emerg Med 30(8):1414-1419.e1CrossRefPubMed Dipti A, Soucy Z, Surana A, Chandra S (2012) Role of inferior vena cava diameter in assessment of volume status: a meta-analysis. Am J Emerg Med 30(8):1414-1419.e1CrossRefPubMed
Metadata
Title
Correlation Between Ultrasound-Measured Diameter and Blood Flow Velocity of the Internal Jugular Veins with the Preoperative Blood Volume in Elderly Patients
Authors
Wei Wang
Qingqing Liu
Zhijian Lan
Xiaohong Wen
Publication date
23-04-2022
Publisher
Springer India
Published in
Indian Journal of Surgery / Issue Special Issue 1/2023
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-022-03418-z

Other articles of this Special Issue 1/2023

Indian Journal of Surgery 1/2023 Go to the issue