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    A new parameter for the diagnosis of hemorrhagic shock: Jugular index
    (W B SAUNDERS CO-ELSEVIER INC, 2012) Akıllı, Nazire Belgin; Cander, Başar; Dündar, Zerrin Defne; Koylu, Ramazan
    Purpose: The purpose of this study is to investigate whether there are any significant changes in the diameter and the area of the internal jugular vein (IJV) during the hemorrhagic shock. Materials and Methods: Healthy volunteers donating blood were included in the study. Arterial blood pressure, pulse rate, anteroposterior (AP) and transverse diameter, and area measurements of the IJV during inspiration and expiration were performed on the volunteers before and after 450 mL of blood donation. Results: A total of 35 volunteers were enrolled in the study. The IJV prehemorrhagic AP diameters during inspiration and expiration were 4.9 +/- 2.2 and 7.9 +/- 3.1 mm, and the posthemorrhagic values were 2.7 +/- 1.6 and 6.6 +/- 3.1 mm (respectively, P < .001 and P = .007). The jugular index-AP was 36% +/- 15% before hemorrhage and 58% +/- 17% after hemorrhage (P < .001). The IJV areas during inspiration and expiration were 0.40 +/- 0.28 and 0.81 +/- 0.51 cm(2) before hemorrhage and were 0.14 +/- 0.15 and 0.61 +/- 0.47 cm(2) after hemorrhage (for both, P < .001). The jugular index-area was found as 47% +/- 18% before hemorrhage and as 73% +/- 18% after hemorrhage (P < .001). Conclusions: We believe that measurement of the IJV and the jugular index is a reliable indicator of class 1 hemorrhagic shock. Itmay be used as a part of focused abdominal sonography for trauma in clinical practice. (C) 2012 Elsevier Inc. All rights reserved.
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    Prediction of arterial blood gas values from venous blood gas values in patients with acute exacerbation of chronic obstructive pulmonary disease
    (TOHOKU UNIV MEDICAL PRESS, 2006) Ak, Ahmet; Ogun, Cemile Oztin; Bayir, Aysegul; Kayis, Seyit Ali; Koylu, Ramazan
    Arterial blood gas (ABG) analysis has an important role in the clinical assessment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, arterial puncture or insertion of an arterial catheter has many drawbacks. The aim of this study was to evaluate whether venous blood gas (VBG) values of pH, partial pressure of carbon dioxide (PCO2) and oxygen (PO2), bicarbonate (HCOA and oxygen saturation (SO2) can reliably predict ABG levels in patients with AECOPD. One hundred and thirty-two patients with a prior diagnosis of COPD presenting with acute exacerbation according to AECOPD criteria were included in this prospective study. AECOPD is defined as a recent increase in cough, wheezing, the volume and purulence of sputum or shortness of breath necessitating a change in regular medication, including corticosteroids or antibiotics. ABG samples were taken immediately after venous sampling, and both were analyzed. Linear regression analysis was performed and equations were established for the estimation of arterial values. The Pearson correlation coefficients for pH, PCO2, HCO3, PO2, and SO2 were 0.934, 0.908, 0.927, 0.252, and 0.296, respectively. There was a significant correlation between ABG and VBG values of pH, PCO2, and HCO3 (P < 0.001)Linear regression equations for the estimation of pH, PCO2, and HCO3 were as follows: arterial pH = 1.004 x venous pH; arterial PCO2 = 0.873 x venous PCO2; and arterial HCO3 = 0.951 x venous HCO3. VBG analysis can reliably predict the ABG values of pH, PCO2 and HCO3 in patients with AECOPD.