Collapsibility of the Right Internal Jugular Vein Predicts Responsiveness to Fluid Administration in Patients Receiving Pressure Support Ventilation: A Prospective Cohort Study

doi:10.14740/jocmr4064

. 2020 Mar;12(3):150-156.

doi: 10.14740/jocmr4064. Epub 2020 Mar 2.

Collapsibility of the Right Internal Jugular Vein Predicts Responsiveness to Fluid Administration in Patients Receiving Pressure Support Ventilation: A Prospective Cohort Study

Yusuke Iizuka^{1

2}, Takeshi Nomura^{3

2}, Masamitsu Sanui¹, Yasuhiro Mochida⁴, Akinori Aomatsu¹, Alan Kawarai Lefor⁵

Affiliations

¹ Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma, Omiya-ku, Saitatama city, Saitama 330-8503, Japan.
² Yusuke Iizuka and Takeshi Nomura contributed equally as first authors.
³ Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan.
⁴ Department of kidney disease and transplant center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura city, Kanagawa 247-8533, Japan.
⁵ Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke city, Tochigi 329-0498, Japan.

PMID: 32231750
PMCID: PMC7092757
DOI: 10.14740/jocmr4064

Collapsibility of the Right Internal Jugular Vein Predicts Responsiveness to Fluid Administration in Patients Receiving Pressure Support Ventilation: A Prospective Cohort Study

Yusuke Iizuka et al. J Clin Med Res. 2020 Mar.

. 2020 Mar;12(3):150-156.

doi: 10.14740/jocmr4064. Epub 2020 Mar 2.

Authors

Yusuke Iizuka^{1

2}, Takeshi Nomura^{3

2}, Masamitsu Sanui¹, Yasuhiro Mochida⁴, Akinori Aomatsu¹, Alan Kawarai Lefor⁵

Affiliations

¹ Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma, Omiya-ku, Saitatama city, Saitama 330-8503, Japan.
² Yusuke Iizuka and Takeshi Nomura contributed equally as first authors.
³ Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan.
⁴ Department of kidney disease and transplant center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura city, Kanagawa 247-8533, Japan.
⁵ Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke city, Tochigi 329-0498, Japan.

PMID: 32231750
PMCID: PMC7092757
DOI: 10.14740/jocmr4064

Abstract

Background: The aim of this study was to evaluate the utility of collapsibility of the internal jugular veins (IJVs) and subclavian veins (SCVs) in comparison with collapsibility of the inferior vena cava (IVC) in patients receiving pressure support ventilation.

Methods: Patients receiving pressure support ventilation were prospectively enrolled when fluid bolus administration was clinically indicated. The antero-posterior diameters of IJVs, SCVs and IVC were measured. Fluid responsiveness was defined as an 8% increase in stroke volume calculated with arterial pulse contour analysis after a passive leg raising maneuver.

Results: Twenty-seven patients (34 measurements) were included. Eighteen measurements were deemed fluid responsive. The area under the receiver operating characteristic curve of collapsibility of the right IJV antero-posterior diameter was 0.88 (95% confidence interval (CI): 0.75 - 0.99), while the area under the ROC curves for the antero-posterior diameter of the left IJV, right SCV, left SCV and the IVC were 0.57 (95% CI: 0.37 - 0.77), 0.61 (95% CI: 0.41 - 0.80), 0.55 (95% CI: 0.35 - 0.76) and 0.57 (95% CI: 0.37 - 0.77), respectively.

Conclusions: These results suggest that collapsibility of the right IJV is a useful predictor of fluid responsiveness in patients receiving pressure support ventilation. Collapsibility of the IVC did not predict fluid responsiveness in these patients.

Keywords: Fluid responsiveness; Inferior vena cava; Internal jugular vein; Pressure support ventilation; Subclavian vein.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

**Figure 1**
Assessment of antero-posterior diameter of the right internal jugular vein by ultrasonography. The diameter was measured 2 cm above the level of the clavicle.

**Figure 2**
The ultrasound short axis view at the closest point where the subclavian vein (SCV) crosses the clavicle.

**Figure 3**
Receiver operating characteristic (ROC) curves of baseline collapsibility of the right internal jugular vein (RIJV) and inferior vena cava (IVC) diameters.

See this image and copyright information in PMC

Cited by

Internal jugular vein ultrasound for the diagnosis of hypovolemia and hypervolemia in acutely ill adults: a systematic review and meta-analysis.
Wang MK, Piticaru J, Kappel C, Mikhaeil M, Mbuagbaw L, Rochwerg B. Wang MK, et al. Intern Emerg Med. 2022 Aug;17(5):1521-1532. doi: 10.1007/s11739-022-03003-y. Epub 2022 Jun 20. Intern Emerg Med. 2022. PMID: 35718838
Internal jugular distensibility index as a predictor of fluid responsiveness in adult patients undergoing elective surgery - A prospective accuracy study.
Aditianingsih D, Heriwardito A, Agusta LS, Leonard EN, Annabelle C. Aditianingsih D, et al. Indian J Anaesth. 2025 Feb;69(2):206-213. doi: 10.4103/ija.ija_457_24. Epub 2025 Jan 29. Indian J Anaesth. 2025. PMID: 40160910 Free PMC article.
Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients-A Narrative Review.
Horejsek J, Kunstyr J, Michalek P, Porizka M. Horejsek J, et al. Diagnostics (Basel). 2022 Feb 16;12(2):513. doi: 10.3390/diagnostics12020513. Diagnostics (Basel). 2022. PMID: 35204603 Free PMC article. Review.
Role of Internal Jugular Vein Collapsibility Index in Predicting Post-spinal Hypotension in Pregnant Women Undergoing Cesarean Section: A Prospective Observational Study.
N P, Sinha M, Kumar M, Ramchandani S, Khetrapal M, Karoo K, Mesa BK. N P, et al. Cureus. 2023 May 23;15(5):e39389. doi: 10.7759/cureus.39389. eCollection 2023 May. Cureus. 2023. PMID: 37362461 Free PMC article.
Pre-operative Ultrasonographic Evaluation of the Internal Jugular Vein Collapsibility Index and Inferior Vena Cava Collapsibility Index to Predict Post Spinal Hypotension in Pregnant Women Undergoing Caesarean Section.
Elbadry AA, El Dabe A, Abu Sabaa MA. Elbadry AA, et al. Anesth Pain Med. 2022 Mar 6;12(1):e121648. doi: 10.5812/aapm.121648. eCollection 2022 Feb. Anesth Pain Med. 2022. PMID: 35433379 Free PMC article.

References

1. Marik PE, Baram M, Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest. 2008;134(1):172–178. doi: 10.1378/chest.07-2331. - DOI - PubMed
1. Osman D, Ridel C, Ray P, Monnet X, Anguel N, Richard C, Teboul JL. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge. Crit Care Med. 2007;35(1):64–68. doi: 10.1097/01.CCM.0000249851.94101.4F. - DOI - PubMed
1. Marik PE, Monnet X, Teboul JL. Hemodynamic parameters to guide fluid therapy. Ann Intensive Care. 2011;1(1):1. doi: 10.1186/2110-5820-1-1. - DOI - PMC - PubMed
1. Barbier C, Loubieres Y, Schmit C, Hayon J, Ricome JL, Jardin F, Vieillard-Baron A. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30(9):1740–1746. doi: 10.1007/s00134-004-2259-8. - DOI - PubMed
1. Feissel M, Michard F, Faller JP, Teboul JL. The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Intensive Care Med. 2004;30(9):1834–1837. doi: 10.1007/s00134-004-2233-5. - DOI - PubMed

LinkOut - more resources

Full Text Sources
- Europe PubMed Central
- PubMed Central

[1] Marik PE, Baram M, Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest. 2008;134(1):172–178. doi: 10.1378/chest.07-2331. - DOI - PubMed

[2] Marik PE, Baram M, Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest. 2008;134(1):172–178. doi: 10.1378/chest.07-2331. - DOI - PubMed

[3] Osman D, Ridel C, Ray P, Monnet X, Anguel N, Richard C, Teboul JL. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge. Crit Care Med. 2007;35(1):64–68. doi: 10.1097/01.CCM.0000249851.94101.4F. - DOI - PubMed

[4] Osman D, Ridel C, Ray P, Monnet X, Anguel N, Richard C, Teboul JL. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge. Crit Care Med. 2007;35(1):64–68. doi: 10.1097/01.CCM.0000249851.94101.4F. - DOI - PubMed

[5] Marik PE, Monnet X, Teboul JL. Hemodynamic parameters to guide fluid therapy. Ann Intensive Care. 2011;1(1):1. doi: 10.1186/2110-5820-1-1. - DOI - PMC - PubMed

[6] Marik PE, Monnet X, Teboul JL. Hemodynamic parameters to guide fluid therapy. Ann Intensive Care. 2011;1(1):1. doi: 10.1186/2110-5820-1-1. - DOI - PMC - PubMed

[7] Barbier C, Loubieres Y, Schmit C, Hayon J, Ricome JL, Jardin F, Vieillard-Baron A. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30(9):1740–1746. doi: 10.1007/s00134-004-2259-8. - DOI - PubMed

[8] Barbier C, Loubieres Y, Schmit C, Hayon J, Ricome JL, Jardin F, Vieillard-Baron A. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30(9):1740–1746. doi: 10.1007/s00134-004-2259-8. - DOI - PubMed

[9] Feissel M, Michard F, Faller JP, Teboul JL. The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Intensive Care Med. 2004;30(9):1834–1837. doi: 10.1007/s00134-004-2233-5. - DOI - PubMed

[10] Feissel M, Michard F, Faller JP, Teboul JL. The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Intensive Care Med. 2004;30(9):1834–1837. doi: 10.1007/s00134-004-2233-5. - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Collapsibility of the Right Internal Jugular Vein Predicts Responsiveness to Fluid Administration in Patients Receiving Pressure Support Ventilation: A Prospective Cohort Study

Affiliations

Collapsibility of the Right Internal Jugular Vein Predicts Responsiveness to Fluid Administration in Patients Receiving Pressure Support Ventilation: A Prospective Cohort Study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

LinkOut - more resources

Full Text Sources