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Internal Jugular Vein Distensibility with Passive Leg Raise: A Diagnostic Approach to Dehydration
Ahmet Aykut1, Burcu Azapoğlu Kaymak2, Tuba Cimilli Öztürk2
1Emergency Department, SBU. Van Education and Research Hospital, Van, Türkiye.
The Journal of Emergency Medicine
|October 25, 2025
Summary
The internal jugular vein distensibility index (IJVDI) showed limited accuracy in detecting dehydration. Changes in cardiac output (ΔCO) and velocity-time integral (ΔVTI) after passive leg raise (PLR) are more reliable ultrasound markers for hypovolemia.
Area of Science:
- Emergency Medicine
- Critical Care
- Diagnostic Imaging
Background:
- Accurate volume status assessment is vital in emergency medicine, particularly for identifying dehydration.
- The internal jugular vein distensibility index (IJVDI) is a noninvasive ultrasound marker for hypovolemia, but its diagnostic utility requires further evaluation.
Purpose of the Study:
- To assess the diagnostic accuracy of IJVDI combined with passive leg raise (PLR) for detecting dehydration.
- To compare the effectiveness of IJVDI with changes in cardiac output (ΔCO) and velocity-time integral (ΔVTI) in identifying dehydration.
Main Methods:
- A prospective diagnostic accuracy study involving 90 participants, with dehydration induced by a 12-hour fasting period.
- Measurements of IJVDI and cardiac output (CO) were taken at baseline and after PLR.
- Diagnostic performance of ΔIJVDI, ΔCO, and ΔVTI was evaluated using receiver operating characteristic analysis.
Main Results:
- IJVDI was significantly higher in the hypovolemic group (18.9 ± 12.3) compared to controls (11.8 ± 4.82).
- IJVDI showed limited diagnostic accuracy (AUC: 0.690).
- ΔCO (AUC: 0.999) and ΔVTI (AUC: 0.928) demonstrated high diagnostic accuracy for dehydration, outperforming IJVDI.
Conclusions:
- IJVDI has limited diagnostic value for dehydration when combined with PLR.
- Ultrasound-based assessment of ΔCO and ΔVTI following PLR offers a more reliable method for detecting dehydration in emergency settings.
- Bedside ultrasonography of CO and VTI with PLR may improve volume status evaluation.
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