Journal of Emergency Practice and Trauma

The efficacy of inferior vena cava diameters and the jugular vein in assessing fluid resuscitation

Document Type : Original Article

Authors

Nahid Zamanimehr 1
Samad Shams Vahdati 1
Hamed Hojjatpanah 2

1 Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

2 Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran

https://doi.org/10.15171/jept.2019.10
Abstract
Objective: Fluid resuscitation is necessary in almost all critical patients. The central venous pressure (CVP) is a well-established method of assessing resuscitation. Recently, there have been attempts to investigate less invasive methods like the diameters of inferior vena cava (IVC) or the jugular vein. We aimed to investigate this method in our research.
Methods: Seventy eight critical patients admitted to the emergency department from April 2018 to December 2018 were studied. The CVP was measured along with the diameters of the two mentioned veins before and during resuscitation. The urinary output was also recorded after administering the fluid. The minimum p-value that would illustrate a significant association was equal to 0.05.
Results: Findings showed that 53.8% of patients were males and 46.2% were females with an average age of 71.48 years. The causes of the critical state were 25.6% hemorrhagic shocks, 30.8% septic shocks and 43.6% hypovolemic shocks. The mean diameter of the jugular vein before and during resuscitation was 27.21 mm and 25.38 mm, respectively (P = 0.1). The mean of IVC diameter before and during resuscitation was 63.33 mm and 57.98 mm, respectively (P <0.001). The CVP was 4.23 mmHg before resuscitation and 5.61 mmHg after resuscitation (P <0.001). With an average urine output of 201.28 cc, a significant correlation was observed with the increase in the CVP, while no such correlations were observed with the decreasing state of the diameters of the IVC or the jugular vein.
Conclusion: Both the IVC diameter and the jugular vein diameter are unable to assess fluid resuscitation independently from respiratory factors

Keywords

Inferior vena cava
Jugular vein
Central venous pressure
Fluid resuscitation
Emergency medicine
Subjects
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Journal of Emergency Practice and Trauma
Volume 5, Issue 2
July 2019
Pages 61-64

  • Receive Date 13 April 2019
  • Revise Date 10 May 2019
  • Accept Date 22 May 2019

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