Bedside ultrasound of the internal jugular vein to assess fluid status and right ventricular function: The POCUS-JVD study

Accurate estimation of fluid status is important in the management of heart failure patients, however, the current methods for bedside assessment can be unreliable or impractical for daily use. Non-ventilated patients were enrolled immediately prior to scheduled right heart catheterization (RHC). Us...

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Bibliographic Details
Published in:The American journal of emergency medicine 2023-08, Vol.70, p.151-156
Main Authors: Vaidya, Gaurang Nandkishor, Kolodziej, Andrew, Stoner, Benjamin, Galaviz, Josue Villegas, Cao, Xiangkun, Heier, Kory, Thompson, Mindy, Birks, Emma, Campbell, Kenneth
Format: Article
Language:English
Subjects:
Bedside ultrasound
Cardiac Catheterization
Cardiology
Catheters
Congestive heart failure
Consent
Emergency medical care
Heart failure
Heart transplants
Humans
Intubation
Jugular vein
Jugular Veins - diagnostic imaging
Patients
POCUS
Pulmonary arteries
Pulmonary artery
Pulmonary hypertension
Respiration
Statistical analysis
Ultrasonic imaging
Ultrasonography
Veins & arteries
Vena Cava, Inferior - diagnostic imaging
Ventilation
Ventricle
Ventricular Function, Right
Volume overload
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Summary:Accurate estimation of fluid status is important in the management of heart failure patients, however, the current methods for bedside assessment can be unreliable or impractical for daily use. Non-ventilated patients were enrolled immediately prior to scheduled right heart catheterization (RHC). Using M-mode, IJV maximum (Dmax) and minimum (Dmin) anteroposterior diameters were measured during normal breathing, while supine. Respiratory variation in diameter (RVD) was calculated as [(Dmax - Dmin)/Dmax] in percentage. Collapsibility with sniff maneuver (COS) was assessed. Lastly, inferior vena cava (IVC) was assessed. Pulmonary artery pulsatility index (PAPi) was calculated. Data was obtained by five investigators. Total 176 patients were enrolled. Mean BMI was 30.5 kg/m2, LVEF 14–69% (range), 38% with LVEF ≤35%. The POCUS of IJV could be performed in all patients in
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2023.05.042