Evaluation of Jugular Venous Distensibility Index in Intravascular Fluid Management and Comparison of the Effectiveness of Noninvasive and Minimally Invasive Methods

Evaluation of Jugular Venous Distensibility Index in Intravascular Fluid Management and Comparison of the Effectiveness of Noninvasive and Minimally Invasive Methods

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.

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