Martos BFD, Larrondo MH, Burgos AD, Orama RV, Agüero MAM

Language: Spanish
References: 12
Page: 2-16
PDF size: 388.65 Kb.

ABSTRACT

Objective: To value the ability of the right internal jugular vein distensibility index to identify the fluid response in critically ill patients ventilated.
Methods: A prospective study was conducted from July 2017 to February 2018 in the Intensive Care Unit - 8B at Hermanos Ameijeiras Surgical Clinical Hospital. The sample consisted of 87 ventilated patients with an indication of intravenous fluid infusion. The distensibility index of the inferior vena cava and the right internal jugular vein was determined by two methods: A-) (maximum diameter in inspiration - minimum in expiration) / minimum diameter; and B-) (maximum diameter in inspiration - minimum in expiration) / average. The fluid response was defined with lower vena cava distensibility index> 18% and> 12% for method A and B, respectively. The ability of the right internal jugular vein distensibility index to discriminate between patients, whether they respond or not to the fluid, was evaluated with the area under the curve of the receiver's operating characteristics.
Results: The correlation between the distensibility index of the inferior vena cava and the right internal jugular vein was significant with method A (r2 = 0.64; p <0.0001) and with method B (r2 = 0.66; p <0.0001). The prevalence of the response to volume was 41.4% and 43.7% with method A and B, respectively. The right internal jugular vein distensibility index had an area under the curve of 0.83 (p <0.0001) with both methods. With method A we had a cut-off value of 5.76%, the sensitivity and specificity was 88.9% and 68.6%, respectively. With method B, there was a cut-off value of 5.60%, the sensitivity was 86.8% and the specificity was 69.4%.
Conclusions: The right internal jugular vein distensibility index is a feasible alternative to the inferior vena cava distensibility index to assess the fluid response in ventilated critically ill patients. Other studies are needed to confirm these results.

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