Mohammad Reza Rouhezamin1, Babak Shekarchi1, Ali Taheri Akerdi2, Shahram Paydar2. 1. Department of Radiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran. 2. Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
OBJECTIVE: To evaluate the accuracy of internal jugular vein waveform to detect early stage of hemorrhagic shock. METHODS: Forty-three volunteers enrolled in our study between November and December 2018. After blood donation of 450cc, the blood donors in the case group underwent color Doppler sonography of internal Jugular Vein. Besides, the clinical and laboratory indicators of shock were evaluated. The same clinical, laboratory and sonographic data was also obtained from the volunteers in the control group, then Chi-square and Student t-test were applied to make comparison between mentioned groups. RESULTS: After excluding five volunteers, eighteen subjects were included in the blood donor group (mean of age: 35.81±8.05) and 20 healthy volunteers enrolled in the control group (mean of age: 34.95± 6.86). The Jugular pulsatility index was significantly smaller in the case group (0.47 ± 0.27 vs. 0.77 ± 0.52). The jugular pulsatility index above 0.91 excluded blood loss (sensitivity=100%). The combination of clinical, laboratory and sonographic data were also represented as two other indices; Jugular Pulsatility-Shock index and Jugular Pulsatility-Shock-Base Deficit index (JPSBDI). These indices were also accurate enough to detect early blood loss (p=0.011 and <0.001, respectively). JPSBDI below 0.38 was highly accurate to rule out blood loss. (Area under the curve: 0.868, sensitivity=95% and specificity=76.47%). CONCLUSION: The internal Jugular vein waveform is accurate to detect early stages of shock. The combination of clinical, laboratory and sonographic data is more promising than each of them, separately.
OBJECTIVE: To evaluate the accuracy of internal jugular vein waveform to detect early stage of hemorrhagic shock. METHODS: Forty-three volunteers enrolled in our study between November and December 2018. After blood donation of 450cc, the blood donors in the case group underwent color Doppler sonography of internal Jugular Vein. Besides, the clinical and laboratory indicators of shock were evaluated. The same clinical, laboratory and sonographic data was also obtained from the volunteers in the control group, then Chi-square and Student t-test were applied to make comparison between mentioned groups. RESULTS: After excluding five volunteers, eighteen subjects were included in the blood donor group (mean of age: 35.81±8.05) and 20 healthy volunteers enrolled in the control group (mean of age: 34.95± 6.86). The Jugular pulsatility index was significantly smaller in the case group (0.47 ± 0.27 vs. 0.77 ± 0.52). The jugular pulsatility index above 0.91 excluded blood loss (sensitivity=100%). The combination of clinical, laboratory and sonographic data were also represented as two other indices; Jugular Pulsatility-Shock index and Jugular Pulsatility-Shock-Base Deficit index (JPSBDI). These indices were also accurate enough to detect early blood loss (p=0.011 and <0.001, respectively). JPSBDI below 0.38 was highly accurate to rule out blood loss. (Area under the curve: 0.868, sensitivity=95% and specificity=76.47%). CONCLUSION: The internal Jugular vein waveform is accurate to detect early stages of shock. The combination of clinical, laboratory and sonographic data is more promising than each of them, separately.
Authors: T M Scalea; A Rodriguez; W C Chiu; F D Brenneman; W F Fallon; K Kato; M G McKenney; M L Nerlich; M G Ochsner; H Yoshii Journal: J Trauma Date: 1999-03
Authors: Christophe Barbier; Yann Loubières; Christophe Schmit; Jan Hayon; Jean-Louis Ricôme; François Jardin; Antoine Vieillard-Baron Journal: Intensive Care Med Date: 2004-03-18 Impact factor: 17.440