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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2018

Open Access 01-12-2018 | Research

Internal jugular vein variability predicts fluid responsiveness in cardiac surgical patients with mechanical ventilation

Authors: Guo-guang Ma, Guang-wei Hao, Xiao-mei Yang, Du-ming Zhu, Lan Liu, Hua Liu, Guo-wei Tu, Zhe Luo

Published in: Annals of Intensive Care | Issue 1/2018

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Abstract

Background

To evaluate the efficacy of using internal jugular vein variability (IJVV) as an index of fluid responsiveness in mechanically ventilated patients after cardiac surgery.

Methods

Seventy patients were assessed after cardiac surgery. Hemodynamic data coupled with ultrasound evaluation of IJVV and inferior vena cava variability (IVCV) were collected and calculated at baseline, after a passive leg raising (PLR) test and after a 500-ml fluid challenge. Patients were divided into volume responders (increase in stroke volume ≥ 15%) and non-responders (increase in stroke volume < 15%). We compared the differences in measured variables between responders and non-responders and tested the ability of the indices to predict fluid responsiveness.

Results

Thirty-five (50%) patients were fluid responders. Responders presented higher IJVV, IVCV and stroke volume variation (SVV) compared with non-responders at baseline (P < 0.05). The relationship between IJVV and SVV was moderately correlated (r = 0.51, P < 0.01). The areas under the receiver operating characteristic (ROC) curves for predicting fluid responsiveness were 0.88 (CI 0.78–0.94) for IJVV compared with 0.83 (CI 0.72–0.91), 0.97 (CI 0.89–0.99), 0.91 (CI 0.82–0.97) for IVCV, SVV, and the increase in stroke volume in response to a PLR test, respectively.

Conclusions

Ultrasound-derived IJVV is an accurate, easily acquired noninvasive parameter of fluid responsiveness in mechanically ventilated postoperative cardiac surgery patients, with a performance similar to that of IVCV.
Appendix
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Metadata
Title
Internal jugular vein variability predicts fluid responsiveness in cardiac surgical patients with mechanical ventilation
Authors
Guo-guang Ma
Guang-wei Hao
Xiao-mei Yang
Du-ming Zhu
Lan Liu
Hua Liu
Guo-wei Tu
Zhe Luo
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2018
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-017-0347-5

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