Anest. intenziv. Med. 2024;35(1):12-18 | DOI: 10.36290/aim.2024.010

Determination of the correlation between ultrasonographically obtained indices of cervical vessels and central venous pressure in critically ill pediatric patientsOriginal Article

Bělohlávek T.¹, Grendár M.², Cibulka M.², Heinige P.³, Berčáková I.¹, Nosáľ S.¹

¹ Klinika detskej anestéziológie a intenzívnej medicíny, Univerzitná nemocnica Martin, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave

² Martinské centrum pre biomedicínu, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave

³ Klinika dětské chirurgie a traumatologie, 3. lékařská fakulta, Univerzita Karlova a Fakultní Thomayerova nemocnice, Praha

Objective: The study aimed to determine the correlation between noninvasively ultrasonographically obtained cervical vessel indices and invasively measured central venous pressure in critically ill pediatric patients.

Design: Prospective observational study. Setting: Department of pediatric intensive care, university hospital.

Material and methods: 77 patients aged 0 to under 19 years with inserted central venous catheter and central venous pressure monitoring requiring admission to the department of intensive care medicine were included in the study. Both spontaneously ventilating patients and patients on artificial pulmonary ventilation, hemodynamically stable patients, and children with circulatory support with low-dose vasoactive agents were included in the study. Each continuous variable (ultrasonographic indices, age, height, weight, central venous pressure) was summarized by descriptive statistics, the distribution of variables was examined, and the correlation was quantified by Spearman correlation. The analysis was performed in the entire data set as well as in individual patient subgroups.

Results: In the group of all measurements, the collapsibility index of the internal jugular vein in B mode (-0.58, p < 0.001), the collapsibility index of the internal jugular vein in M mode (-0.45, p <0.001), and the ratio of the internal jugular vein in 30- and 0-degree position (0.43, p < 0.001) had the highest correlation with central venous pressure. In the group of spontaneously ventilated patients, the highest correlation with central venous pressure was also found for the collapsibility index of internal jugular vein in B mode (-0.51, p < 0.001), and in patients on artificial pulmonary ventilation for the collapsibility index of internal jugular vein in B mode (- 0.55, p < 0.001) and the distensibility index of internal jugular vein in B mode (-0.55, p < 0.001). The correlation of the ratio of the internal jugular vein and common carotid artery with central venous pressure was low in all measurements group (0.25, p < 0.05), low in the spontaneously ventilated group (0.3, p < 0.05) and none in the artificially ventilated group (0.04).

Conclusion: The results of the present study suggest that ultrasonographically obtained cervical vessel indices may provide a non-invasive, easily repeatable, bedside alternative to central venous pressure examination in the estimation of intravascular filling in critically ill pediatric patients.

Keywords: ultrasonography, central venous pressure, cervical vessels, correlation.

Received: October 7, 2023; Revised: February 15, 2024; Accepted: March 6, 2024; Prepublished online: March 15, 2024; Published: March 28, 2024  Show citation