Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 19 , ISSUE 10 ( 2015 ) > List of Articles

BRIEF COMMUNICATION

The dynamics of changing internal jugular veins diameter based on increasing head elevation angle

Anton A. Kasatkin, Aleksandr Urakov, Anna Nigmatullina

Keywords : Internal jugular vein, intracranial pressure, ultrasound scanning

Citation Information : Kasatkin AA, Urakov A, Nigmatullina A. The dynamics of changing internal jugular veins diameter based on increasing head elevation angle. Indian J Crit Care Med 2015; 19 (10):610-612.

DOI: 10.4103/0972-5229.167040

License: CC BY-ND 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2015; The Author(s).


Abstract

Context: Venous outflow from the cranial cavity occurs mainly through the internal jugular vein (IJV). The increase in venous outflow through IJV is possible by head elevation. IJV collapse may indicate the reduction of blood volume in the vein and show the head elevation effectiveness. Aims: The aim of this study is to examine the impact of head elevation on IJV size. Subjects and Methods: IJV ultrasound scanning in 31 healthy volunteers was carried after gradual head elevation at 15°, 30°, and 45°. Maximum and minimum IJV diameters were recorded. Mean ± standard deviation, median, range, and collapsibility index were calculated. Results: Thirty-one volunteers were involved (19 males), their average age was 37.0 ± 11.5 years. Increasing the head elevation angle by 15°, 30° and 45° resulted in a decrease in IJV diameter in the right and left sides in all patients. The occurrence of the vein walls collapse corresponds to the collapsibility index equal to 100%. The results showed that 100% collapsibility index was recorded in 6 patients (19%) at 15° head elevation, in 12 patients (39%) at 30°, in 11 patients (35%) at 45°. In two volunteers (6%), 100% collapsibility index was not recorded even at maximum 45° head elevation. Conclusions: Ultrasound IJV scanning during gradual head elevation together with the collapsibility index calculation could be useful guidance for the venous outflow assessment. In order to prove and extend the study findings, more research is needed.


PDF Share
  1. Rangel-Castillo L, Robertson CS. Management of intracranial hypertension. Crit Care Clin 2006;22:713-32.
  2. Sankhyan N, Vykunta Raju KN, Sharma S, Gulati S. Management of raised intracranial pressure. Indian J Pediatr 2010;77:1409-16.
  3. Durward QJ, Amacher AL, Del Maestro RF, Sibbald WJ. Cerebral and cardiovascular responses to changes in head elevation in patients with intracranial hypertension. J Neurosurg 1983;59:938-44.
  4. Kim WH, Lee JH, Lee SM, Kim CS, Kang R, Yoo CS, et al. The effect of passive leg elevation and/or trendelenburg position on the cross-sectional area of the internal jugular vein in infants and young children undergoing surgery for congenital heart disease. Anesth Analg 2013;116:178-84.
  5. Schreiber SJ, Lambert UK, Doepp F, Valdueza JM. Effects of prolonged head-down tilt on internal jugular vein cross-sectional area. Br J Anaesth 2002;89:769-71.
  6. Goldberg RN, Joshi A, Moscoso P, Castillo T. The effect of head position on intracranial pressure in the neonate. Crit Care Med 1983;11:428-30.
  7. Meixensberger J, Baunach S, Amschler J, Dings J, Roosen K. Influence of body position on tissue-pO2, cerebral perfusion pressure and intracranial pressure in patients with acute brain injury. J Neurosurg 1983;59:938-44.
  8. Feldman Z, Kanter MJ, Robertson CS, Contant CF, Hayes C, Sheinberg MA, et al. Effect of head elevation on intracranial pressure, cerebral perfusion pressure, and cerebral blood flow in head-injured patients. J Neurosurg 1992;76:207-11.
  9. Stawicki SP, Braslow BM, Panebianco NL, Kirkpatrick JN, Gracias VH, Hayden GE, et al. Intensivist use of hand-carried ultrasonography to measure IVC collapsibility in estimating intravascular volume status: Correlations with CVP. J Am Coll Surg 2009;209:55-61.
  10. Kent A, Patil P, Davila V, Bailey JK, Jones C, Evans DC, et al. Sonographic evaluation of intravascular volume status: Can internal jugular or femoral vein collapsibility be used in the absence of IVC visualization? Ann Thorac Med 2015;10:44-9.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.