Internal jugular distensibility index as a predictor of fluid responsiveness in adult patients undergoing elective surgery - A prospective accuracy study.

IF 2.9 Q1 ANESTHESIOLOGY
Indian Journal of Anaesthesia Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI:10.4103/ija.ija_457_24
Dita Aditianingsih, Aldy Heriwardito, Laksmi Senja Agusta, El Nissi Leonard, Chrisella Annabelle
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引用次数: 0

Abstract

Background and aims: Assessing the intravascular volume is necessary in patients undergoing surgery, but predicting how the body will respond to fluid can be challenging. Evaluation of the internal jugular vein distensibility index (IJV-DI) is an alternative method to determine intravascular volume status. This study aims to determine the suitability of measuring stroke volume by using IJV-DI measurement compared with transthoracic echocardiography in assessing the fluid responsiveness in elective surgery patients.

Methods: This prospective study involved 79 subjects undergoing elective surgery under general anaesthesia. Following anaesthesia induction, IJV-DI and stroke volume measurements were performed before and after fluid administration. Subjects experiencing an increase in stroke volume of more than 10% were categorised as responders. The primary outcome was the suitability of IJV-DI in determining fluid responsiveness compared to transthoracic echocardiography in elective surgery patients. The data were then analysed to assess its diagnostic value using the receiver operator characteristic (ROC) curve, the appropriate cut-off point using the Youden index, and the correlation using Spearman's correlation test.

Results: A total of 45 subjects were responders. Our analysis revealed an area under the curve (AUC) value of 0.871 (95% CI: 0.790, 0.951). The optimal cut-off value was found at an internal jugular vein distensibility index of >12.62% with a sensitivity of 84.4% and a specificity of 79.4%. A moderate positive correlation existed between the index and stroke volume increase (r = 0.535, P < 0.001).

Conclusion: IJV-DI assessment is compatible with transthoracic echocardiography stroke volume measurement for evaluating elective surgery patients' fluid response.

颈内扩张指数作为择期手术成年患者体液反应的预测指标——一项前瞻性准确性研究
背景和目的:在接受手术的患者中,评估血管内容积是必要的,但预测身体对液体的反应可能具有挑战性。颈内静脉扩张指数(IJV-DI)的评估是确定血管内容量状态的另一种方法。本研究旨在确定IJV-DI测量与经胸超声心动图测量在评估择期手术患者液体反应性方面的适用性。方法:本前瞻性研究纳入79例在全身麻醉下进行择期手术的患者。麻醉诱导后,在给液前后分别测量IJV-DI和脑卒中容积。脑卒中量增加超过10%的受试者被归类为反应者。主要结果是IJV-DI与经胸超声心动图在择期手术患者中测定液体反应性的适用性。然后对数据进行分析,以评估其诊断价值,使用受试者操作员特征(ROC)曲线,使用约登指数确定适当的截止点,并使用Spearman相关检验评估相关性。结果:有应答者45名。我们的分析显示曲线下面积(AUC)为0.871 (95% CI: 0.790, 0.951)。最佳临界值为颈内静脉扩张指数>12.62%,敏感性84.4%,特异性79.4%。指数与脑卒中容量增加呈中度正相关(r = 0.535, P < 0.001)。结论:IJV-DI评估与经胸超声心动图卒中容积测量可用于评价择期手术患者的体液反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
44.80%
发文量
210
审稿时长
36 weeks
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