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Anaesthesiology Intensive Therapy 2022Ultrasound evaluation of inferior vena cava and internal jugular vein dia-meters predicts the intravascular volume status in critical patients. The aim of the present...
Ultrasound imaging and central venous pressure in spontaneously breathing patients: a comparison of ultrasound-based measures of internal jugular vein and inferior vena cava.
BACKGROUND
Ultrasound evaluation of inferior vena cava and internal jugular vein dia-meters predicts the intravascular volume status in critical patients. The aim of the present study was to determine which ultrasound-derived index is most strongly associated with central venous pressure (CVP). Furthermore, we determined the utility of selected variables in predicting low volume status (CVP < 8 mmHg).
METHODS
All patients underwent a transthoracic echocardiogram, vascular ultrasound examination, invasive central venous pressure, and intra-abdominal pressure determination. The following indexes were calculated: inferior vena cava diameter, internal jugular vein maximum diameter, collapsibility index, and internal jugular vein ratio.
RESULTS
41 spontaneously breathing patients were recruited. Central venous pressure significantly correlated with inferior vena cava diameter ( r = 0.35, P = 0.02), internal jugular vein ratio ( r = 0.35, P = 0.03), and internal jugular vein maximum diameter ( r = 0.58, P < 0.001). The inferior vena cava collapsibility index did not show any association. The areas under the receiver operating characteristic curves to discriminate a low central venous pressure (< 8 mmHg) were the following: internal jugular vein diameter 0.80 (95% CI: 0.63-0.90); inferior vena cava diameter 0.66 (95% CI: 0.49-0.80); and internal jugular vein ratio 0.68 (95% CI: 0.51-0.82).
CONCLUSIONS
The internal jugular vein diameter, the internal jugular vein ratio, and the inferior vena cava diameter showed a significant correlation with central venous pressure. In particular, the internal jugular vein diameter showed good accuracy in predicting a low central venous pressure.
Topics: Central Venous Pressure; Echocardiography; Humans; Jugular Veins; Ultrasonography; Vena Cava, Inferior
PubMed: 35416439
DOI: 10.5114/ait.2022.114469 -
Italian Journal of Pediatrics Nov 2023The purpose of this study was to summarize the early clinical results and surgical experience of repairing the right common carotid artery and the right internal jugular...
BACKGROUND
The purpose of this study was to summarize the early clinical results and surgical experience of repairing the right common carotid artery and the right internal jugular vein after ECMO treatment in neonates.
METHODS
We retrospectively collected the clinical data of 16 neonates with circulatory and respiratory failure who were treated with ECMO via the right common carotid artery and the right internal jugular vein in our hospital from June 2021 to December 2022. The effects of repairing the common carotid artery and internal jugular vein were evaluated.
RESULTS
All 16 patients successfully underwent right cervical vascular cannulation, and the ECMO cycle was successfully established. Twelve patients were successfully removed from ECMO. The right common carotid artery and the right internal jugular vein were successfully repaired in these 12 patients. There was unobstructed arterial blood flow in 9 patients, mild stenosis in 1 patient, moderate stenosis in 1 patient and obstruction in 1 patient. There was unobstructed venous blood flow in 10 patients, mild stenosis in 1 patient, and moderate stenosis in 1 patient. No thrombosis was found in the right internal jugular vein. Thrombosis was found in the right common carotid artery of one patient.
CONCLUSION
Repairing the right common carotid artery and the right internal jugular vein after ECMO treatment in neonates was feasible, and careful surgical anastomosis techniques and standardized postoperative anticoagulation management can ensure early vascular patency. However, long-term vascular patency is still being assessed in follow-up.
Topics: Infant, Newborn; Humans; Extracorporeal Membrane Oxygenation; Jugular Veins; Retrospective Studies; Constriction, Pathologic; Carotid Artery, Common
PubMed: 37950294
DOI: 10.1186/s13052-023-01556-y -
PloS One 2018The elasticity of the internal jugular vein (IJV) is a major determinant of cerebral venous drainage and right atrium venous return. However, the level of genetic... (Clinical Trial)
Clinical Trial
AIMS
The elasticity of the internal jugular vein (IJV) is a major determinant of cerebral venous drainage and right atrium venous return. However, the level of genetic determination of IJV dimensions, compliance and distensibility has not been studied yet.
METHODS
170 adult Caucasian twins (43 monozygotic [MZ] and 42 dizygotic [DZ] pairs) were involved from the Italian twin registry. Anteroposterior and mediolateral diameters of the IJV were measured bilaterally by ultrasonography. Measurements were made both in the sitting and supine positions, with or without Valsalva maneuver. Univariate quantitative genetic modeling was performed.
RESULTS
Genetic factors are responsible for 30-70% of the measured properties of IJV at higher venous pressure even after adjustment for age and gender. The highest level of inheritance was found in the supine position regarding compliance (62%) and venous diameter during Valsalva (69%). Environmental and measurement-related factors instead are more important in the sitting position, when the venous pressure is low and the venous lumen is almost collapsed. The range of capacity changes between the lowest and highest intraluminal venous pressure (full distension range) are mainly determined by genetic factors (58%).
CONCLUSIONS
Our study has shown substantial heritability of IJV biomechanics at higher venous pressures even after adjustment for age and gender. These findings yield an important insight to what degree the geometric and elastic properties of the vascular wall are formed by genetic and by environmental factors in humans.
Topics: Adult; Blood Pressure; Female; Humans; Jugular Veins; Male; Middle Aged; Twins, Dizygotic; Twins, Monozygotic
PubMed: 29561848
DOI: 10.1371/journal.pone.0192948 -
CNS Neuroscience & Therapeutics Nov 2022Differentiating between acquired stenosis (pathologic) and anatomical slenderness (physiologic) of internal jugular vein (IJV) remain ambiguous. Herein, we aimed to...
BACKGROUND AND PURPOSES
Differentiating between acquired stenosis (pathologic) and anatomical slenderness (physiologic) of internal jugular vein (IJV) remain ambiguous. Herein, we aimed to compare the similarities and differences between the two entities.
METHODS
Patients who underwent head and neck computer tomography (CT) and brain magnetic resonance imaging (MRI) were enrolled in this case-control study from January 2016 through October 2021.
RESULTS
1487 eligible patients entered final analysis totally. 803 patients had bilateral IJVs imaging without IJV stenosis-related symptoms and presented in three ways: right IJV slenderness (10.5%, n = 85), left IJV slenderness (48.4%, n = 388), and symmetric IJVs (41.1%, n = 330). In patients with asymmetric IJVs, their bilateral jugular foramina were also asymmetric. All involved asymmetric IJVs presented as slenderness without surrounding abnormal collaterals and credible cloudy-like white matter hyper-intensity (WMH). Their cerebral arterial perfusion statuses on brain MR-PWI maps were normal. In contrast, the major patients with IJV stenosis presented with signs and symptoms such as headaches, head noise, etc. In CE-MRV maps, local stenosis of the IJV was surrounded by abnormal venous collaterals in contrast to the lack of abnormal venous collaterals for patients with IJV slenderness. And in CTV maps, the caliber of jugular foramina was mismatched with the transverse diameter of IJV. Moreover, in MRI maps of most of these patients, a cloudy-like WMHs were distributed symmetrically in bilateral periventricular and/or centrum semi vales. These patients also had symmetrical cerebral arterial hypo-perfusion. Seven patients underwent stenting of the IJV stenosis correction, their WMHs attenuated or disappeared subsequently.
CONCLUSIONS
Imaging features in addition to clinical symptoms can be used to differentiate between physiologic IJV slenderness and pathologic IJV stenosis. Notable imagine-defining features for IJV stenosis include local stenosis surrounded by abnormal venous collaterals, cloudy-like WMHs, and mismatch between the transverse diameter of IJV and the caliber of the jugular foramina.
Topics: Case-Control Studies; Constriction, Pathologic; Humans; Jugular Veins; Magnetic Resonance Imaging; Neck
PubMed: 35919952
DOI: 10.1111/cns.13924 -
Postgraduate Medical Journal Aug 1962
Topics: Disease; Humans; Jugular Veins; Neck; Varicose Veins
PubMed: 14451970
DOI: 10.1136/pgmj.38.442.470 -
BMC Neurology Jun 2019Internal jugular vein stenosis (IJVS), characterized by a series of clinical manifestations, such as head and neck symptoms, visual and ear symptoms, as well as sleep... (Review)
Review
BACKGROUND
Internal jugular vein stenosis (IJVS), characterized by a series of clinical manifestations, such as head and neck symptoms, visual and ear symptoms, as well as sleep disorder, has been receiving attention in recent years. However, its' etiologies are not fully understood.
CASE PRESENTATION
We report a cases series of IJVS induced by styloid oppression. We define it as the stylo-jugular type of Eagle syndrome (ES).
CONCLUSIONS
Our study reveals that external oppression, especially by styloid process, is an important etiology of IJVS. The stylo-jugular ES diagnosis can be identified by Computed tomography venography. Whether stylo-jugular ES can be corrected by styloidectomy requires further investigation.
Topics: Aged; Computed Tomography Angiography; Constriction, Pathologic; Female; Humans; Jugular Veins; Male; Middle Aged; Ossification, Heterotopic; Phlebography; Temporal Bone
PubMed: 31164090
DOI: 10.1186/s12883-019-1344-0 -
Journal of Biomedical Optics Nov 2022The internal jugular veins (IJV) are critical cerebral venous drainage pathways that are affected by right heart function. Cardiovascular disease and microgravity can...
SIGNIFICANCE
The internal jugular veins (IJV) are critical cerebral venous drainage pathways that are affected by right heart function. Cardiovascular disease and microgravity can alter central venous pressure (CVP) and venous return, which may contribute to increased intracranial pressure and decreased cardiac output. Assessing jugular venous compliance may provide insight into cerebral drainage and right heart function, but monitoring changes in vessel volume is challenging.
AIM
We investigated the feasibility of quantifying jugular venous compliance from jugular venous attenuation (JVA), a noncontact optical measurement of blood volume, along with CVP from antecubital vein cannulation.
APPROACH
CVP was progressively increased through a guided graded Valsalva maneuver, increasing mouth pressure by 2 mmHg every 2 s until a maximum expiratory pressure of 20 mmHg. JVA was extracted from a 1-cm segment between the clavicle and midneck. The contralateral IJV cross-sectional area (CSA) was measured with ultrasound to validate changes in the vessel size. Compliance was calculated using both JVA and CSA between four-beat averages over the duration of the maneuver.
RESULTS
JVA and CSA were strongly correlated (median and interquartile range) over the Valsalva maneuver across participants (r = 0.986, [0.983, 0.987]). CVP more than doubled on average between baseline and peak strain (10.7 ± 4.4 vs. 25.8 ± 5.4 cmH2O; p < 0.01). JVA and CSA increased nonlinearly with CVP, and both JVA- and CSA-derived compliance decreased progressively from baseline to peak strain (49% and 56% median reduction, respectively), with no significant difference in compliance reduction between the two measures (Z = - 1.24, p = 0.21). Pressure-volume curves showed a logarithmic relationship in both CSA and JVA.
CONCLUSIONS
Optical jugular vein assessment may provide new ways to assess jugular distention and cardiac function.
Topics: Humans; Jugular Veins; Central Venous Pressure; Ultrasonography; Valsalva Maneuver
PubMed: 36385200
DOI: 10.1117/1.JBO.27.11.116005 -
Medicine Apr 2023Venous aneurysm is a rare vascular disease. Studies reveal that patients with fusiform internal jugular vein aneurysms are not suitable for embolization.
RATIONALE
Venous aneurysm is a rare vascular disease. Studies reveal that patients with fusiform internal jugular vein aneurysms are not suitable for embolization.
PATIENT CONCERNS
Two treatment options are considered, either bypass the aneurysm via stenting or excision of the lesion site and anastomosis using an artificial graft. The advantages of excision bypass include the absence of endoleak and stent migration; however, a larger wound and longer operation time are required for it.
DIAGNOSES
Physical examination revealed a swelling in the right neck area. Head and neck computed tomography was performed for the survey. It revealed a 27.22 × 25.07 × 58.17 mm internal jugular fusiform aneurysm.
INTERVENTIONS
Vein excision was performed while using hemoclamps to control inflow and outflow, and a graft was anastomosed for bypass using an 8 mm Maquet graft.
OUTCOMES
The wound recovery was favorable, with no signs of infection, and the pain was under control.
LESSONS
The patient had a contrast-enhanced head and neck computed tomography, and the images efficiently diagnosed a venous aneurysm. This patient had refractory pain, which was a significant indication of the operation. We decided by ourselves on the duration of the interval of following up. We used excision and bypassing with graft, and the result was beneficial.
Topics: Humans; Jugular Veins; Aneurysm; Veins; Stents; Tomography, X-Ray Computed
PubMed: 37083804
DOI: 10.1097/MD.0000000000033582 -
Kidney360 Sep 2022
Topics: Catheters, Indwelling; Dyspnea; Humans; Jugular Veins; Renal Dialysis; Weight Loss
PubMed: 36245650
DOI: 10.34067/KID.0002842022 -
Journal of Veterinary Cardiology : the... Jun 2022An 11-month-old Staffordshire Bull Terrier was referred with a two-month history of fluctuating unilateral jugular groove swelling, which appeared to enlarge after...
An 11-month-old Staffordshire Bull Terrier was referred with a two-month history of fluctuating unilateral jugular groove swelling, which appeared to enlarge after exercise. There was no history of trauma. Multimodal imaging findings (using transdermal and transesophageal ultrasound and dual phase computed tomography angiography) were consistent with large, saccular, left jugular vein aneurysm, running parallel to the left carotid artery. There did not appear to be any arteriovenous communication present. There were no cardiac abnormalities found on echocardiography. Following surgical excision, histopathological analysis supported the clinical suspicion of a congenital external jugular venous aneurysm.
Topics: Aneurysm; Angiography; Animals; Computed Tomography Angiography; Dog Diseases; Dogs; Jugular Veins; Ultrasonography
PubMed: 35235883
DOI: 10.1016/j.jvc.2022.01.006