Is There an Optimal Positive End-Expiratory Pressure to Measure the Internal Jugular Vein Collapsibility Index? A Pilot Study in Mechanically Ventilated Patients

Abstract

Background: Hemodynamic monitoring its early stabilization is very important in critically ill patients. Evaluating the Internal jugular vein diameter during respiratory cycles by the means of Point-of care ultrasound provides an important, easily available and precise index for monitoring hemodynamic status; a new method which is called Internal Jugular Vein Collapsibility Index (IJV-CI). Any events that alters intrathoracic volumes and pressures may affect this index. In this study we investigate the effects of various levels of positive end-expiratory pressure on this index. Methods: Thirty mechanically ventilated patients were studied. We used three different PEEP levels (0, 5 and 10 cmH2o) and point-of-care ultrasound evaluation of IJV (Internal Jugular Vein) diameter to determine the IJV-CI. The analysis were performed using SPSS V.25.0. Results: Patients were included men (76.6%) and women (33.3%). The mean age of patients was 39.65±3.4 for men and 42.71± 9.34 for women. The IJV-CI were 20.71±11.77 and 24.25±11.46 in PEEP=0 and PEEP=10 cmH20 groups respectively. In 5cmH20-PEEP group median and interquartile range were 16.45(14.8). The IJV-CI in three different PEEP levels were not statistically significantly different. Conclusion: According to the finding of this study, we found no evidence of an optimal PEEP level to measure The IJV-CI.

Keywords

• Internal jugular vein collapsibility index
• Positive end-expiratory pressure
• Hemodynamic monitoring
• Intensive Care Units (ICU) patients