Prediction of Fluid Responsiveness Based on the External Jugular Vein Distensibility Index After Changes in Volume Status in Healthy, Anesthetized, and Mechanically Ventilated Dogs.

ABSTRACT:

Objective

To investigate whether point-of-care ultrasound of the external jugular vein (EJV) can predict fluid responsiveness (FR) in healthy, anesthetized, mechanically ventilated dogs.

Design

Prospective, nonrandomized experimental study.

Setting

University-based small animal research facility.

Animals

Six healthy Beagle dogs.

Interventions

Dogs were investigated at six time points (TPs): baseline (TP₁); 20 mL/kg of circulating blood was collected over 10 min (TP₂); half of the collected blood was autotransfused for 10 min (TP₃); remaining collected blood was autotransfused for 10 min (TP₄); 0.9% normal saline (10 mL/kg for 10 min) was administered (TP₅); and an additional dose of 0.9% normal saline (10 mL/kg for 10 min) was administered (TP₆). Hemodynamic variables, Doppler images of the left ventricular outflow tract (LVOT), and M-mode images of the EJV were obtained at each TP. FR was evaluated during TP_3-6. FR was defined as an increase of >15% in the LVOT velocity time integral following fluid challenge, while other results were defined as fluid nonresponsiveness (FNR). The external jugular vein distensibility index (EJVDI) was calculated as follows: [(maximal EJV diameter - minimal EJV diameter)/minimal EJV diameter] × 100%. The maximal EJV diameter was measured during inspiration, and the minimal EJV diameter was measured during expiration. In addition, gray zones indicating the range of diagnostic uncertainty were proposed in various indices for predicting FR.

Measurements and main results

Among the 24 fluid challenges performed between TP₃ and TP₆, 11 FR and 13 FNR were identified. The area under the receiver operating characteristic curve for the EJVDI in predicting FR was 0.92, with a cut-ff value of 22.7%, and the gray zone was identified as 22.6%-27.3%.

Conclusions

The EJVDI could be used to predict FR in healthy, anesthetized, mechanically ventilated dogs. Further studies are required before point-of-care ultrasound of the EJV can be applied in various clinical settings.

SUBMITTER: Seo D 

PROVIDER: S-EPMC12322366 | biostudies-literature | 2025 May-Jun

REPOSITORIES: biostudies-literature