Application of internal jugular vein diameter by ultrasound and respiratory variation index in the treatment of post-cardiac arrest syndrome

Zhang Jun; Chen Wen-teng; Song Wei; Li Min; Zhan Feng; Wang Wei; Jing Xiang-xiang

doi:10.3969/j.issn.1002-1949.2017.11.015

Abstract：Objective We investigate the application of internal jugular vein diameter (IJVD) by ultrasound and respiratory variation index (RVI) in the treatment of post-cardiac arrest syndrome (PCAS),and the relationship between IJVD and RVI with CVP,in order to rapidly assess the CVP of patients with PCAS,to further improve the application of bedside ultrasound in emergency ICU,and to study the relationship between IJVD and RVI with the prognosis in patients with PCAS.Methods The patients who restored autonomic circulation by CPR were PCAS group,and the healthy volunteers were control group.We measured the sectional area of internal jugular vein by ultrasonic probe respectively on 2 h,12 h,24 h,3 d and 7 d after CRP,and record the CVP simultaneously,the right and left internal jugular vein cross-sectional area of the maximum and minimum values were recorded as RVmax,RVmin,LVmax and LVmin.In addition,we calculated RVI of internal jugular vein.The volunteers in control group were asked to take the same position with PCAS group,breath calmly,and were measured in the end of inhalation and the end of expiration.We compared the differences of the cross-sectional area of IJVD,RVI in the two groups,and analyzed the correlations of RVmax,RVmix,LVmax,LVmin,RVrvi,LVrvi and CVP.Results According to the comparison of 2 h,12 h,24 h,3 d,7 d after cardiopulmonary resuscitation,RVmax,RVmix,LVmax,LVmin increased to (2.11 ± 1.05) cm2 (1.74±0.96) cm2,(1.61 ±0.91) cm2,(1.43±0.87) cm2(P＜0.01),and the differences were obvious.RVrvi and LVrvi were obviously reduced to (18.8 ± 13.11) ％,(18.73-± 11.78) ％ (all P ＜0.01).RVmax,RVmix,LVmax and LVmin were positively correlated with CVP,while RVrvi and LVrvi were negatively correlated with CVP.Conclusion IJVD measured by bedside ultrasound can assess the CVP and blood volume of patients with PCAS,and can guide the resuscitation of fluids rapidly and noninvasively.