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

Kerleroux, Basile; Pasco, Jeremy; Dupuis, Mathieu; Eustache, Marine; Lemrabott, Ahmed Tall; Jouzel, Charlotte; Albert, Catherine M.; Janot, Kévin; Morel, Baptiste; Pruna, A

doi:10.1002/jcu.22571

J of Clinical Ultrasound

2018

DOI: 10.1002/jcu.22571

|View full text |Cite

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

Basile Kerleroux

Jeremy Pasco

Mathieu Dupuis

et al.

Abstract: CVPni appears as a noninvasive and reliable technique. Further studies are required to confirm these results and to assess the direct clinical impact of this new method.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2021

2022

Publication Types

Select...

Article3

Relationship

Self Cite0

Independent3

Authors

Journals

Cited by 3 publications

(1 citation statement)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One prior study found that elevated JVP on physical examination had a moderate sensitivity for the diagnosis of PH [9] but that JVP-exam underestimates invasively measured RAP. This has also been demonstrated for JVP-US in non-PH populations [5,10], with underestimation of RAP by 0.5-5 cmH 2 O. Interestingly, we found that JVP-US tended to be higher than JVP-exam.…”

supporting

confidence: 84%

Jugular venous ultrasound predicts outcomes in pulmonary hypertension outpatients

et al. 2021

View full text Add to dashboard Cite

Assessment of jugular venous pressure ( JVP) is a classic physical examination manoeuvre that serves as an estimate of right atrial pressure (RAP). Although JVP was rated by experts as the most important physical examination finding to monitor response to therapy in pulmonary hypertension (PH) patients [1], it has been understudied in PH. Since RAP is an accurate predictor of outcome in PH [2, 3], determining whether clinically assessed JVP (as a non-invasive surrogate for RAP) also predicts outcomes is an important, unanswered question. Since JVP can be difficult to measure on physical examination due to obesity and challenges distinguishing between carotid and jugular pulsations, ultrasound measures of JVP have been developed [4,5]. We hypothesised that: 1) JVP measurement could be more reliably obtained by ultrasound ( JVP-US) than JVP by physical examination ( JVP-exam); 2) JVP-US would correlate with same-day B-type natriuretic peptide (BNP), another non-invasive surrogate of right heart function; and 3) JVP-US would predict time to clinical worsening (TTCW).This was a prospective, observational study at a United States Pulmonary Hypertension Associationaccredited Comprehensive Care Center enrolling patients from July 2016 to April 2018, with follow-up ending April 2021. Consecutive patients from any World Symposium on Pulmonary Hypertension (WSPH) subgroup [6] were eligible for inclusion. Informed consent was obtained from each patient prior to enrolment (IRB #9403, clinicaltrials.gov NCT02873039).The REVEAL 2.0 risk score [2], a multi-parameter risk prediction score, was calculated using the most recent data from the medical record. The research team was blinded to patient's clinical status and BNP, and the treating physician was blinded to the results of the ultrasound measurement. A physical examination estimate of JVP ("JVP-exam") was performed by the treating physician by adding 5 cmH 2 O to the measured vertical height of the right internal jugular vein (IJV) V-wave above the sternal angle with the patient seated at a 45-degree angle. A handheld ultrasound device (General Electric Vscan) was used to estimate JVP in the right IJV [4] with the patient in the same position. The probe was placed in a horizontal position in the anterior triangle of the neck and then rotated 90 degrees to obtain a longitudinal view of the jugular vein. The vertical height of the IJV tapering above the sternal angle clavicle plus 5 cmH 2 O was used to estimate JVP ("JVP-US") (figure 1a). JVP measurements were taken at end-expiration.Baseline descriptive statistics were calculated and reported as mean±SD or percentages. Bland-Altman analysis was conducted to compare JVP-exam to JVP-US. Pearson correlation coefficients were calculated for both JVP-exam and JVP-US in relation to log-transformed BNP. Participants were followed prospectively for their first clinical worsening event (first occurrence of death, lung transplantation, PH-related hospitalisation, or worsening functional class (FC) with addition of PH-specific medicati...

show abstract

supporting

confidence: 84%

Jugular venous ultrasound predicts outcomes in pulmonary hypertension outpatients

et al. 2021

View full text Add to dashboard Cite

show abstract

Ultrasound-guided venous pressure measurement

Gutwein

Thalhammer

2022

Vasa

View full text Add to dashboard Cite

Summary: Current standard technique for venous pressure measurement is still invasive, requiring insertion of a catheter. Additionally, clinical estimation of central venous pressure (CVP) has proven unreliable compared to invasive methods. Meanwhile, different non-invasive ultrasound guided modalities may provide a valid alternative to invasive venous pressure measurement. Particularly promising is a novel compression ultrasound (CUS) which combines ultrasound properties with a tissue pressure manometer enabling even further future applications. This review provides an overview using ultrasound guided non-invasive venous pressure measurement (UGPni) in clinical trials so far and focuses on three objectives: (1) To summarize the main methods using UGPni for central venous pressure measurement (2) To outline the key findings of previous clinical trials for UGPni regarding CVP measurement with primary focus on novel compression ultrasound of a forearm vein (3) To point out limitations and possible future clinical implications of these ultrasound modalities UGPni represents an easy-to-perform and safe alternative to invasive “gold standard” diagnostic tools for measuring central venous pressure. After a brief introduction, non-specialist personnel using a portable ultrasound device can apply this method in a feasible way. Of all mentioned methods in this review CUS is the method of choice underscoring its ability to assess a patient’s CVP categories correctly. Furthermore, detection of non-invasive central venous pressure in the emergency room represents an independent predictor for cardiac rehospitalization in patients with decompensated heart failure, thus helping in risk stratification as well as being an additive tool in general hemodynamic management of critically ill patients. This review concludes a significant role for ultrasound guided non-invasive venous pressure measurement suitable for a wide range of everyday clinical practice. However, further studies are warranted to proof a causal relationship in this regard.

show abstract

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

Baz

Ibrahim

El-Fishawy

et al. 2021

Egypt J Radiol Nucl Med

View full text Add to dashboard Cite

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.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

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

Abstract: CVPni appears as a noninvasive and reliable technique. Further studies are required to confirm these results and to assess the direct clinical impact of this new method.

Cited by 3 publications

References 30 publications

Jugular venous ultrasound predicts outcomes in pulmonary hypertension outpatients

Jugular venous ultrasound predicts outcomes in pulmonary hypertension outpatients

Ultrasound-guided venous pressure measurement

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

Contact Info

Product

Resources

About