Comparison of internal jugular vein diameter and brachial artery peak velocity variation in predicting fluid responsiveness / 中华麻醉学杂志

ABSTRACT

Objective To compare internal jugular vein diameter and brachial artery peak velocity variation (VVp) in predicting fluid responsiveness.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,of New York Heart Association I,aged 18-64 yr,scheduled for elective gastrointestinal surgery under general anesthesia,were included in this study.Six percent hydroxyethyl starch 130/0.47 ml/kg was infused at a rate of 0.4 ml · kg-1 · min-1 after induction of anesthesia.The patients with the changing rate of stroke volume variation (ASVV) more than or equal to 15％ were included in responsiveness group and patients with ASVV less than 15％ were included in non-responsiveness group after volume expansion.Immediately after volume expansion and at 3 min after volume expansion,mean arterial pressure,central venous pressure and heart rate were recorded,the maximum diameter of the internal jugular vein at the end of inspiration (IJVmax) and the minimum diameter of the internal jugular vein at end of expiration (IJVmin) and brachial artery peak velocity were measured using an ultrasonic instrument,and the variation of internal jugular vein respiration (VIJV) and VVp were calculated.The receiver operating characteristic curve was used to evaluate the accuracy of IJV IJVmin,VIJV and VVp in predicting fluid responsiveness.Results There were 31 patients in responsiveness group and 29 patients in non-responsiveness group.Compared with non-responsiveness group,mean arterial pressure,central venous pressure,IJVmax and IJVmin were significantly decreased and heart rate,VIJV and VVp were increased immediately after volume expansion in responsiveness group (P＜0.05).The areas under receiver operating characteristic curve (AUC) of IJV IJVmin,VIJV and VVp were 0.753,0.948,0.837 and 0.832,respectively.AUC IJVmax,AUCVIJV and AUCVVp were significantly decreased when compared with AUC IJVmin (P＜0.05).Conclusion The accuracy of IJVmax is higher than that of VVp in predicting intraoperative fluid responsiveness in the patients.