Correlation between internal jugular vein ultrasound and Electrical Cardiometry in assessment of fluid responsiveness in patients undergoing Coronary Artery Bypass Grafting surgery

Background: One of the most common cardiac surgery procedures performed globally is coronary artery bypass graft (CABG). For almost 40 years, people suffering from ischemic heart disease have been given the gift of life by undergoing coronary artery bypass grafting (CABG). Aim: The main objective was to determine the accuracy of predicting fluid responsiveness in adults having coronary artery bypass graft surgery by evaluating the relationship between electrical cardiometry-measured stroke volume variation (SVV) and ultrasonography of the internal jugular vein, which measures vessel distensibility. The secondary objective was to determine whether electrical cardiometry-measured thoracic fluid content (TFC) might be used as a supplement to evaluate fluid responsiveness. Subjects and methods: From March 2023 through April 2025, 40 adult patients slated for elective CABG were enrolled in this prospective observational case-control study at Al-Azhar University Hospitals in Cairo, Egypt. Results: TFC after induction were insignificantly different between both groups and were significantly lower after HES 6%, closure of sternum and before ICU in responder patients than non-responder patients. TFC can significantly predict fluid responder patients(P<0.001 and AUC=0.866) at a cut-off of ≤31 with 92.59% sensitivity, 61.54% specificity, 83.3% PPV and 80% NPV. SVV can significantly predict fluid responder patients(P<0.001 and AUC=0.742) at a cut-off>9 with 62.96% sensitivity, 38.46% specificity, 68% PPV and 33.3% NPV. Conclusion: TFC and SVV proved to be effective predictors of fluid responsiveness, with cut-off values of ≤31 for TFC and>9 for SVV, yielding sensitivities of 92.59% and 62.96%, and specificities of 61.54% and 38.46%, respectively. Furthermore, a positive correlation was observed between SVV and IJVDI, which supports the integration of electrical cardiometry and IJV ultrasound as reliable tools for guiding fluid management in cardiac surgery.