Intravascular volume assessment using internal jugular vein ultrasonography in pediatric renal transplant surgery: a prospective observational study

Abstract

Purpose Assessment of the intravascular volume status during surgery is challenging, especially in pediatric patients. Ultrasound has become a versatile noninvasive modality for assessing volume status. This study aimed to evaluate the reliability of ultrasonographic internal jugular vein (IJV) dimensions as a new tool to assess the intravascular volume status in pediatric patients undergoing living donor renal transplant surgery. Patients and methods This prospective observational study included pediatric renal transplant recipients, aged 3–12 years, weighing more than 10 kg, and having an end-stage renal disease. Hemodynamic data (heart rate, systolic, diastolic, and mean blood pressures), central venous pressure (CVP), sonographic measurement of IJV (diameter and cross-sectional area), and left ventricular end-diastolic area (LVEDA) were measured 1 min after induction, before clamping of renal vessels, and after declamping of renal vessels. The correlations between the ultrasonographic IJV dimensions and both LVEDA (primary outcome) and CVP were evaluated. Results Overall, 18 pediatric patients (12 females, six males) with end-stage renal disease were eligible for this study. The mean age was 9.33±2.57 years, and the mean weight was 21.67±5.99 kg. There was a poor correlation between IJV dimensions (diameter and cross-sectional area) and both LVEDA and CVP at the three-time points of assessments. Conclusion Ultrasonographic IJV dimensions (diameter and cross-sectional area) were not reliable for assessing intravascular volume status in living donor renal transplant surgery in pediatric patients.