Diagnostic accuracy of internal jugular vein ultrasound in quantification of the central venous pressure for hemodialysis patients

Abstract

Background Assessment of the central venous pressure (CVP) is an essential hemodynamic parameter for monitoring the dialyzing patients. Our objective of the present study is to investigate the accuracy of CVP measurement by internal jugular vein US in comparison to the direct measurement by the central venous catheters for hemodialysis patients. We included 106 patients; where their CVP was assessed in two different non invasive US methods (CVPni) separately and in combination and the obtained measurements were correlated to the invasive measurements (CVPi) by catheters. Results By method 1, there is a highly significant positive correlation between CVPni and CVPi (ρ < 0.001) and a Pearson correlation coefficient (r = 0.913 n = 93), and by method 2, there is also a highly significant positive correlation between the CVPni and CVPi in both groups (r = 0.832, 95%, n = 106, p < 0.001), 1.935 was the cut-off point for prediction of CVP ≥ 10cmH20. For differentiation between patients with CVP < 10cmH20 and ≥ 10cmH20, the accuracy measures (sensitivity, specificity, PPV, NPV, and overall accuracy) were 100%, 79.31%, 74.47%, 100%, and 87.10% by method 1, and were 91.11%, 85.48%, 82.00%, 92.98%, and 87.85% by method 2, while the combination of both methods had gained 88.57%, 89.66%, 83.78%, 92.86%, and 89.25%, respectively. Conclusion The US offered a reliable and non-invasive tool for monitoring CVP. The present study has a novelty of combining more than one US method and this had reported higher accuracy measures and outperformed the use of a single method.