Assessment of Intravascular Volume Status in Mechanically Ventilated Critically Ill Patients
Conditions
Keywords
fluid management, hemodynamic monitoring, Right Internal Jugular Vein, Inferior Vena Cava, Distensibility Index, Pleth Variability Index, Pulse Pressure Variation, Stroke Volume Variation, Intravascular Volume Status
Brief summary
Assessment of intravascular volume status is an important component of hemodynamic management in critically ill patients. Several noninvasive and minimally invasive parameters, including the pleth variability index (PVI), pulse pressure variation (PPV), stroke volume variation (SVV), and ultrasonographic measurements of venous diameter variation, can be used for this purpose. Although the inferior vena cava distensibility index (IVC-DI) is commonly evaluated using ultrasonography, visualization of the inferior vena cava may be technically difficult or time-consuming in some patients. The right internal jugular vein is more superficial and may therefore provide a faster and more accessible alternative. The primary aim of this prospective observational study is to evaluate the correlation and agreement between the right internal jugular vein distensibility index (RJV-DI) and IVC-DI in mechanically ventilated adult intensive care unit patients. The secondary aims are to compare the correlations of RJV-DI and IVC-DI with PVI, PPV, and SVV and to compare the acquisition times of the two ultrasonographic measurements. The study will assess whether RJV-DI may provide a practical and faster alternative for hemodynamic assessment, particularly when visualization of the inferior vena cava is difficult.
Interventions
DIAGNOSTIC_TESTPleth variability index
Pleth variability index
DIAGNOSTIC_TESTPulse pressure variation
Pulse pressure variation
DIAGNOSTIC_TESTStroke volume variation
Stroke volume variation
DIAGNOSTIC_TESTRight jugular vein distensibility index
Right jugular vein distensibility index
DIAGNOSTIC_TESTInferior Vena Cava Distensibility Index
Inferior Vena Cava Distensibility Index
Sponsors
Gaziosmanpasa Research and Education Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years or older * Admission to the intensive care unit * Receiving invasive mechanical ventilation at the time of assessment * Availability of PVI, PPV, and SVV measurements during the hemodynamic assessment * Availability of technically adequate right internal jugular vein and inferior vena cava ultrasonographic measurements obtained during the same assessment session
Exclusion criteria
* Age younger than 18 years * Presence of cardiac arrhythmia * Not receiving invasive mechanical ventilation at the time of assessment * Inability to obtain technically adequate right internal jugular vein or inferior vena cava ultrasonographic images * Unavailable or incomplete PVI, PPV, or SVV measurements
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlation Between the Right Internal Jugular Vein Distensibility Index and Inferior Vena Cava Distensibility Index | During a single assessment session on Day 1 | The association between the right internal jugular vein distensibility index (RJV-DI) and inferior vena cava distensibility index (IVC-DI), both expressed as percentages, will be quantified using Spearman's rank correlation coefficient. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Difference in Measurement Acquisition Time Between RJV-DI and IVC-DI | During a single assessment session on Day 1 | The time required to obtain technically adequate RJV-DI and IVC-DI measurements will be recorded in seconds. The paired acquisition times will be compared to determine which ultrasonographic assessment can be performed more rapidly. |
Countries
Turkey (Türkiye)
Outcome results
None listed