New Method for Noninvasive Quantification of Central Venous Pressure by Ultrasound

Abstract

Background— The central venous pressure (CVP) is essential for assessing the cardiac preload and circulating blood volume in clinic. The invasive CVP measurement by central venous catheter has been reported with various complications. The aim of this study was to develop a new noninvasive method for quantification of CVP by ultrasound. Methods and Results— Seventy-six patients who had their CVP monitored for intraoperative or postoperative management were recruited. By accurate location of the collapse point of the internal jugular vein and the center of the right atrium using ultrasound imaging, the height of the fluid column between those 2 points was measured as the noninvasive CVP (CVPn). A total of 118 measurements were performed and compared with the invasive CVP (CVPi). Linear correlation analysis revealed a significant correlation between CVPi and CVPn (preoperative measurements, r =0.90; P <0.01 and postoperative measurements, r =0.93; P <0.01). Bland–Altman plots showed a good agreement between CVPi and CVPn with the mean difference of 0.22 mm Hg (preoperative measurements) and −0.09 mm Hg (postoperative measurements), respectively. Conclusions— The new noninvasive CVP quantification method based on the location of both the collapse point of internal jugular vein and the center of right atrium by ultrasound could be used as a reliable approach for monitoring the hemodynamic status in clinic.

Ultrasonographic assessment of the internal jugular vein for the estimation of central venous pressure in hemodialysis patients: A preliminary study

“…Therefore, we compared the ultrasonographic measurement of the collapsing point of the IJV and the invasive measurement of CVP via the conventional column filled up with a 5% sucrose solution. As in recent ICU studies, we found a close relationship between CVPni and CVPi. Our preliminary results suggest that CVPni may be considered as an easily reproducible and reliable method to evaluate and monitor blood volume in hemodialysis patients.…”

“…Finally, CVPni is a noninvasive method that can be easily used in daily clinical practice. Thanks to the democratization of compact ultrasound devices in nonspecialized environment, learning the technique became quite easy . The jugular vein remains readily accessible in obese patients, unlike the IVC.…”

“…CVP was recently estimated in intensive care units (ICU) by the ultrasonographic examination of the internal jugular vein (CVPni) . This seems to be a promising alternative to the direct measurement of CVP from a central venous catheter (CVPi), which is not performed routinely in hemodialysis patients, mainly because most of them are dialyzed using an arteriovenous fistula and consequently do not have a central venous line available.…”

Comparison between noninvasive measurement of central venous pressure using near infrared spectroscopy with an invasive central venous pressure monitoring in cardiac surgical Intensive Care Unit

“…Xing et al . [ 24 ] reported a new method for noninvasive quantification of CVP, where center of the RA and both cephalic, basilic and brachial veins had a good correlation. Their study showed bias of 0.22 mmHg with LOA of −2.16–2.59 during preoperative measurement which was comparable to the present study.…”

A Simple Method for Noninvasive Quantification of Pressure Gradient Across the Pulmonary Valve

“…By adding the noninvasively estimated right ventricular end-diastolic pressure to the end-diastolic PVPG, the pulmonary artery diastolic pressure may be calculated. The right ventricular end-diastolic pressure equals the right atrial diastolic pressure 21 , which can be obtained from the central venous pressure measurement by neck ultrasound 28 . Thus, the noninvasive PVPO method may be clinically useful as a routine assessment of pulmonary artery diastolic pressure.…”