Correlation of Internal Jugular Venous Collapsibility Index with Central Venous Pressure to Assess Volume Status in Critically ill Patients

Résumé

Introduction: Intravascular volume status assessment and hemodynamic monitoring plays an important role in management of critically ill patients. One of the important parameters in the hemodynamic evaluation of critically ill patients is central venous pressure (CVP). Sonographic evaluation of the Internal Jugular Venous (IJV) Collapsibility Index can be used as an alternative to CVP as an indirect measure of volume status. Objective: To find out the correlation between IJV collapsibility index and CVP for assessment of volume status in critically ill patients. Methods & Materials: This cross-sectional study was carried out in Non-COVID ICU at the Department of Anaesthesia, Pain, Palliative & Intensive Care, Dhaka Medical College Hospital (DMCH), Dhaka from January 2022 to December 2022. A total of 97 study subjects were included as per the inclusion and exclusion criteria. CVP was measured by CVP manometer and IJV diameter with collapsibility index was measured by bedside ultrasonography. Specificity and Sensitivity of IJV collapsibility index was calculated and correlation between CVP and IJV collapsibility index was done. For all statistical tests, p value of <0.05 was considered as statistically significant. Results: The mean age was 38.13±11.83 years, majority of the patients were female (51.5%). This study showed significant negative correlation of IJV collapsibility index with central venous pressure (r = -.553, p<0.001), systolic blood pressure (r = .372, p<0.001) and diastolic blood pressure (r= -.420, p<0.001). In present study showed that CVP of <8 cmH₂O was chosen as a clinically significant cutoff value for low CVP level. Internal jugular venous collapsibility index ≥34% considered as best cut off value of hypovolemia. The diagnostic performance test value was sensitivity 86.1%, specificity 73.8%, PPV 65.9%, and NPV 90.0% and accuracy 78.4%. Conclusion: This study reveals that IJV collapsibility index ≥34% correlates with hypovolemia in critically ill non ventilated patients.