Bedside ultrasound of the internal jugular vein to assess fluid status and right ventricular function: The POCUS-JVD study

Seeing beneath the surface: Harnessing point-of-care ultrasound for internal jugular vein evaluation

“…Multiple techniques have been described to assess CVP by IJV ultrasound. Based on available data, these methods encompass measuring the vertical height of the blood column in the IJV[ 13 - 16 ], utilizing the IJV height-to-width ratio (aspect ratio)[ 17 , 18 ], IJV collapsibility index (IJV-CI)[ 13 , 17 , 19 - 22 ], IJV distensibility index[ 23 ], measuring the maximal anteroposterior diameter of the IJV (AP-IJV Dmax)[ 18 , 24 ], calculating the difference in the percentage of the IJV cross-sectional area (IJV-CSA) or diameter before and after the Valsalva maneuver[ 25 , 26 ], and combining IJV vertical height with right atrial depth measured with echocardiography[ 27 , 28 ].…”

“…The IJV-CI is calculated by its respiratory variation, (IJVmax – IJVmin)/IJVmax expressed in percentage (Figure 3 ). The actual RAP cannot be quantified, but studies[ 13 , 21 , 22 ] have shown that an IJV-CI of approximately ≤ 30% signifies an elevated CVP of ≥ 8 mmHg, demonstrating good sensitivity and specificity. Worthy of particular mention, in a study by Leal-villarreal et al [ 21 ] in patients with cirrhosis, IJV-CI (anteroposterior diameter 2 cm above the sternoclavicular joint) ≤ 24.8% was better at predicting a CVP ≥ 8 mmHg with 100% sensitivity and 97.1% specificity outperforming IVC POCUS.…”

A Clinician’s Guide to the Implementation of Point-of-Care Ultrasound (POCUS) in the Outpatient Practice

“…Excellent examples would include urinary bladder in order to check a post-void residual volume, jugular venous pressure for those patients in whom an intravascular volume assessment is difficult, a knee (or other joint) exam to perform ultrasound guided injections, or hand joints to assess for synovitis. 34 - 40 …”

Collaborative peri-transplant management of volume status, hypertension, and immunosuppression: enhancing kidney transplants for better outcomes

“…It should also be noted that the prognostic value of POCUS in predicting renal outcomes have come into question as of recently [ 15 ]. As an alternative, the technically less difficult evaluation of JVP by ultrasound (uJVP) was shown in multiple studies to have promising test characteristics for predicting right atrial pressure (right sided filling pressure) [ 16 , 17 ].…”