Abstract
Prediction of fluid responsiveness (FR) is a critical step in management of patients with septic shock. Using ultrasound in detection of inferior vena cava (IVC) diameters and collapsibility is established in mechanically ventilated patients; however its use in spontaneous breathing patients is still controversial [1]. Few studies reported a correlation between internal jugular vein dimensions and central venous pressure (CVP) [2, 3] but no data are available about the use of IJV dimensions in detection of FR.
Highlights
Prediction of fluid responsiveness (FR) is a critical step in management of patients with septic shock
Transthoracic echocardiography (TTE) was done to determine FR which was defined as increase in sub-aortic velocity time integral (VTI) > 15% after fluid bolus 7 ml/Kg
Area under receiver operating characteristic (AUROC) curve for prediction of FR was: 0.51(0.27-0.73) for central venous pressure (CVP) with sensitivity 27% and specificity 100% at cutoff value 9 mmHg, 0.5(0.27-0.72) for IJV aspect ratio, 0.56(0.33-0.78) for IJV/Common carotid artery (CCA), 0.54(0.31-0.77) for IJV surface area, 0.52(0.28-0.74) for inferior vena cava (IVC) collapsibility index, 0.72(0.53-0.92) for IVC minimum diameter with sensitivity 45% and specificity 89% at cutoff value 0.3 cm, 0.76(0.48-0.90) for IVC maximum diameter with sensitivity 82% and specificity 67% at cutoff value 1.5 cm
Summary
Prediction of fluid responsiveness (FR) is a critical step in management of patients with septic shock. Few studies reported a correlation between internal jugular vein dimensions and central venous pressure (CVP) [2,3] but no data are available about the use of IJV dimensions in detection of FR
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