The role of internal jugular vein Doppler ultrasound in predicting hypovolemic shock in polytrauma patients
Hojatollah Khajehpour1 , Mohammad Javad Behzadnia2
1Marine Medicine Research Center, Baqiyatallah University of Medical Sciences, tehran, Iran
2Trauma Research Center, Baqiyatallah University of Medical Sciences, tehran, Iran
Corresponding Author: Hojatollah Khajehpour ,Tel: +982181262012, Fax: 982181262012, Email: hojatollah.khajehpour@yahoo.com
Received: July 4, 2021;  Accepted: August 29, 2021.  Published online: August 29, 2021.
ABSTRACT
Purpose:
The purpose of this study was to evaluate the accuracy of the internal jugular vein (IJV) Doppler ultrasound in prediction of 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. IJV Doppler ultrasound was performed for all patients with stable vital signs and negative extended focused assessment with sonography for trauma. Jugular pulsatility index (JPI) values were calculated using the equation (Vmax –Vmin)/Vmax. Clinical and laboratory indices of hypovolemic shock were recorded at the time of admission. Patients were subsequently divided into two groups: those with hemorrhagic shock (n = 36) and those without (n = 39) based on the occurrence of hemorrhagic shock within 6 hours after admission. Finally, the results were compared.
Results:
IJV Doppler sonographic parameters (JPI, V-min, and Vmax – Vmin) indicated 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 <0.0001). The sensitivity, specificity, and discriminant ability of JPI in detecting hemorrhagic shock were 86.11% and 82.05% (AUC = 0.853, P <0.0001), respectively.
Conclusion:
IJV Doppler evaluations can reliably predict hemorrhagic shock in polytrauma patients with stable vital signs. Ultrasound can be used in combination with clinical signs and laboratory findings to diagnose patients at risk of hypovolemic shock.
Keywords: Doppler ultrasound; Polytrauma patients; Internal jugular vein; Hypovolemic shock
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