Internal jugular vein collapsibility index associated with hypovolemia in the intensive care unit patients

Abstract

Objective To evaluate the correlation between the internal jugular vein (IJV) collapsibility index and hypovolemia in intensive care unit (ICU) patients, using point of care ultrasound imaging. Methods A prospective observational study was conducted in an urban tertiary care teaching hospital, in the surgical ICU. Intensivist point-of-care sonographers performed IJV ultrasound on 31 ICU patients who were diagnosed to be hypovolemic or euvolemic by their treating ICU physicians. Results Hypovolemic ICU patients (16 of 31) were 50% male and 75% white with a mean age of 63 (±19) years. The variables measured between the hypovolemic and euvolemic ICU patients were the mean arterial pressure, heart rate, respiratory rate, central venous pressure (CVP). Their correlation with hypovolemia was significant (p<0.05). The ROC curve analysis found the IJV collapsibility index ≥39% correlated best with hypovolemic ICU patient with a sensitivity of 87.5% and specificity 100%. The area under ROC curve for IJV collapsibility index was 0.938, with no significant difference to CVP with the area under ROC curve of 0.87 (p = 0.467). Conclusion IJV collapsibility index can be identified by intensivist point-of-care sonographers in the hypovolemic and euvolemic ICU patients. The presence of IJV collapsibility index greater than 39% may be associated with hypovolemia in ICU patients. © Springer-Verlag 2010.