|
|
|
|
|
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 |
Department of Emergency, Hainan General Hospital, Haikou 570000, China |
|
|
Abstract Objective〓〖WTBZ〗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. 〖WTHZ〗Methods〓〖WTBZ〗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. 〖WTHZ〗Results〓〖WTBZ〗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. 〖WTHZ〗Conclusion〓〖WTBZ〗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.
|
Received: 31 July 2017
|
Corresponding Authors:
Department of Emergency, Hainan General Hospital, Haikou 570000, China
|
|
|
|
[1]Lund-Kordabl I,Olasveengen TM,Lorem T,et al.Improving outcome after out-of-hospital cardiac arrest by strengthening weak links of the local Chain of Survival;quality of advanced llfe support and post-resuacitation care[J].Resuscitation, 2010, 81(4):422-426.
[2]Nolan JP, Laver SR, Welch CA, et al. Outcome following admission to UK intensive care units after cardiac arrest: a secondary analysis of the ICNARC Case Mix Programme Database[J]. Anaesthesia, 2007, 62(12): 1207-1216.
[3]Rosamond W, FIegaIK, FurieK, et al. Heart disease and stroke statistics-2008 update: a report from theAmerican Heart Association Statistics Committeeand Stroke Statistics Subcommittee[J]. CircuIation, 2008, 117 (4):e25-146.
[4]Kilgannon JH, Roberts BW, Reihl LR, et al. Early arterial hypotension is common in the post-cardiac arrest syndrome and associated with increased in-hospital mortality[J]. Resuscitation, 2008, 79(3):410-416.
[5]浙江省早期规范化液体复苏治疗协作组.危重病严重脓毒症/脓毒性休克患者早期规范化液体复苏治疗——多中心、前瞻性、随机、对照研究[J]. 中国危重病急救医学, 2010, 22(6):331-334.
[6]Vignon P. Evaluation of fluid responsiveness in ventilated septic patients:back to venous return[J]. Intensive Care Med, 2004, 30(9):1699-1701.
[7]Lipton B. Estimation of central venous pressure by ultrasound of the internal jugular vein[J]. Am J Emerg Med, 2000, 18(4):432-434.
[8]Jang T, Aubin C, Naunheim R, et al. Ultrasonography of the internal jugular vein in patients with dyspnea without jugular venous distention on physical examination[J]. Ann Emerg Med, 2004, 44(2):160-168.
[9]洪玉才, 张茂, 何小军,等. 急诊床旁应用超声FAST方案快速评估多发伤的初步研究[J]. 中华急诊医学杂志, 2010, 19(10):1066-1069. |
|
|
|