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      The role of internal jugular vein Doppler ultrasonography in predicting hypovolemic shock in polytrauma patients

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      https://www.riss.kr/link?id=A108471995

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      다국어 초록 (Multilingual Abstract)

      Purpose: The aim of this study was to evaluate the accuracy of internal jugular vein (IJV) Doppler ultrasonography in predicting hypovolemic shock in polytrauma patients.Methods: This prospective observational study was conducted on 75 multiple trauma...

      Purpose: The aim of this study was to evaluate the accuracy of internal jugular vein (IJV) Doppler ultrasonography in predicting hypovolemic shock in polytrauma patients.Methods: This prospective observational study was conducted on 75 multiple trauma patients (injury severity score >15) with a mean age of 33.00±9.57 years. IJV Doppler ultrasonography was performed in all patients with stable vital signs and a negative extended focused assessment with sonography for trauma. Jugular pulsatility index (JPI) values were calculated using the equation (V<sub>max</sub>-V<sub>min</sub>)/V<sub>max</sub>. Clinical and laboratory indices of hypovolemic shock were recorded at the time of admission. Patients were subsequently divided into those with hemorrhagic shock (n=36) and those without (n=39) based on the occurrence of hemorrhagic shock within 6 hours after admission. The results were compared between these groups.Results: IJV Doppler ultrasound parameters (JPI, V<sub>min</sub>, and V<sub>max</sub>-V<sub>min</sub>) showed significant differences between the two groups. The JPI values of patients with hemorrhagic shock were significantly lower than those in the control group (0.43±0.21 vs. 0.78±0.24, P<0.001). The sensitivity, specificity, and discriminant ability (area under the curve) of JPI with a cutoff of 0.58 in detecting hemorrhagic shock were 86.11%, 82.05%, and 0.853 (P<0.001), respectively.Conclusion: IJV Doppler ultrasonography can reliably predict hemorrhagic shock in polytrauma patients with stable vital signs. Ultrasonography can be used in combination with clinical signs and laboratory findings to diagnose patients at risk of hypovolemic shock.

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      참고문헌 (Reference) 논문관계도

      1 Juhl-Olsen P, "Ultrasound of the inferior vena cava does not predict hemodynamic response to early hemorrhage" 45 : 592-597, 2013

      2 Unluer EE, "Ultrasonography of jugular vein as a marker of hypovolemia in healthy volunteers" 31 : 173-177, 2013

      3 Rahman NH, "Ultrasonographic assessment of inferior vena cava/abdominal aorta diameter index : a new approach of assessing hypovolemic shock class 1" 9 : 8-, 2016

      4 Witting MD, "Standing shock index : an alternative to orthostatic vital signs" 35 : 637-639, 2017

      5 Sefidbakht S, "Sonographic measurement of the inferior vena cava as a predictor of shock in trauma patients" 14 : 181-185, 2007

      6 Maar SP, "Searching for the Holy Grail : a review of markers of tissue perfusion in pediatric critical care" 24 : 883-887, 2008

      7 Mutschler M, "Renaissance of base deficit for the initial assessment of trauma patients : a base deficit-based classification for hypovolemic shock developed on data from 16, 305 patients derived from the TraumaRegister DGU(R)" 17 : R42-, 2013

      8 Carter EA, "Redistribution of blood flow after thermal injury and hemorrhagic shock" 65 : 1782-1788, 1988

      9 Teixeira PG, "Preventable or potentially preventable mortality at a mature trauma center" 63 : 1338-1346, 2007

      10 Monnet X, "Prediction of fluid responsiveness by a continuous non-invasive assessment of arterial pressure in critically ill patients : comparison with four other dynamic indices" 109 : 330-338, 2012

      1 Juhl-Olsen P, "Ultrasound of the inferior vena cava does not predict hemodynamic response to early hemorrhage" 45 : 592-597, 2013

      2 Unluer EE, "Ultrasonography of jugular vein as a marker of hypovolemia in healthy volunteers" 31 : 173-177, 2013

      3 Rahman NH, "Ultrasonographic assessment of inferior vena cava/abdominal aorta diameter index : a new approach of assessing hypovolemic shock class 1" 9 : 8-, 2016

      4 Witting MD, "Standing shock index : an alternative to orthostatic vital signs" 35 : 637-639, 2017

      5 Sefidbakht S, "Sonographic measurement of the inferior vena cava as a predictor of shock in trauma patients" 14 : 181-185, 2007

      6 Maar SP, "Searching for the Holy Grail : a review of markers of tissue perfusion in pediatric critical care" 24 : 883-887, 2008

      7 Mutschler M, "Renaissance of base deficit for the initial assessment of trauma patients : a base deficit-based classification for hypovolemic shock developed on data from 16, 305 patients derived from the TraumaRegister DGU(R)" 17 : R42-, 2013

      8 Carter EA, "Redistribution of blood flow after thermal injury and hemorrhagic shock" 65 : 1782-1788, 1988

      9 Teixeira PG, "Preventable or potentially preventable mortality at a mature trauma center" 63 : 1338-1346, 2007

      10 Monnet X, "Prediction of fluid responsiveness by a continuous non-invasive assessment of arterial pressure in critically ill patients : comparison with four other dynamic indices" 109 : 330-338, 2012

      11 Eastridge BJ, "Outcomes of traumatic hemorrhagic shock and the epidemiology of preventable death from injury" 59 : 1423-1428, 2019

      12 Dutton RP, "Low-pressure resuscitation from hemorrhagic shock" 40 : 19-30, 2002

      13 Rouhezamin MR, "Internal jugular vein waveform : a new insight to detect early stage of hemorrhagic shock" 7 : 263-268, 2019

      14 Celik OF, "Initial inferior vena cava and aorta diameter parameters measured by ultrasonography or computed tomography does not correlate with vital signs, hemorrhage or shock markers in trauma patients" 24 : 351-358, 2018

      15 Schefold JC, "Inferior vena cava diameter correlates with invasive hemodynamic measures in mechanically ventilated intensive care unit patients with sepsis" 38 : 632-637, 2010

      16 Sakka SG, "Hemodynamic monitoring in the critically ill patient:current status and perspective" 2 : 44-, 2015

      17 Brasel KJ, "Heart rate : is it truly a vital sign?" 62 : 812-817, 2007

      18 World Health Organization, "Guidelines on assessing donor suitability for blood donation"

      19 Zhang Y, "Evaluation of four volume-based image registration algorithms" 34 : 317-322, 2009

      20 Lipton B, "Estimation of central venous pressure by ultrasound of the internal jugular vein" 18 : 432-434, 2000

      21 Sinert R, "Effect of normal saline infusion on the diagnostic utility of base deficit in identifying major injury in trauma patients" 13 : 1269-1274, 2006

      22 Pucheu A, "Doppler ultrasonography of normal neck veins" 22 : 367-373, 1994

      23 Worapratya P, "Correlation of caval index, inferior vena cava diameter, and central venous pressure in shock patients in the emergency room" 6 : 57-62, 2014

      24 Caputo ND, "Comparing biomarkers of traumatic shock: the utility of anion gap, base excess, and serum lactate in the ED" 33 : 1134-1139, 2015

      25 Sun N, "Cerebral hemodynamic change and metabolic alteration in severe hemorrhagic shock" 812 : 217-223, 2014

      26 Tokunaga K, "Cardiac variation of internal jugular vein as a marker of volume change in hemorrhagic shock" 54 : 717-722, 2020

      27 Pacagnella RC, "A systematic review of the relationship between blood loss and clinical signs" 8 : e57594-, 2013

      28 Akilli NB, "A new parameter for the diagnosis of hemorrhagic shock : jugular index" 27 : 530-, 2012

      29 Mutschler M, "A critical reappraisal of the ATLS classification of hypovolaemic shock : does it really reflect clinical reality?" 84 : 309-313, 2013

      30 Dunham MP, "A comparison of base deficit and vital signs in the early assessment of patients with penetrating trauma in a high burden setting" 48 : 1972-1977, 2017

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