Correlation between Ultrasound Measurements of Internal Jugular Venous Diameter and Central Venous Pressure Measurements as a Follow up Tool in Severe Sepsis

Abstract

Background: Sepsis is one of the primary causes of death among intensive care unit (ICU) patients. Proper and controlled fluid administration is needed in septic patients to overcome generalized vasodilatation and capillary leak that worsen septic patients. Objective: Current study aimed to evaluate ultrasonographic measurements of internal jugular vein (IJV) as a predictor for volume status and to define its role in improvement of haemodynamic, urine output and mortality rate among septic patients. Patients and Methods: Fifty-one adult septic patients were enrolled from ICU of Mansoura University Hospitals who already inserted central venous catheter (CVC) for appropriate indication took part in an observational study. Continuous monitoring of hemodynamic parameters was carried out. Ultrasound guided IJV diameter was assessed when patients were lying down, then central venous pressure (CVP) measurements were taken. Signs of hypovolemia, such as tachycardia, hypotension, and acidosis were assessed clinically. Results: Data from 51 septic patients who were spontaneously breathing were evaluated. There was significant positive correlation between CVP and both width and height (at admission, 3h or 24 hours following the admission). Systolic blood pressure (SBP) demonstrated statistically significant positive correlation at admission (width and height) and after 24 hours of admission with width. Diastolic blood pressure (DBP) and mean arterial pressure (MAP) demonstrated statistically significant positive correlation at admission (width and height) and after 3 hours of admission with height. Conclusions: Ultrasonographic measurement of the IJV is a good predictor of fluid response in septic patients.