Ultrasound Accurately Reflects the Jugular Venous Examination but Underestimates Central Venous Pressure

Deol, Gur Raj S.; Collett, Nicole D.; Ashby, A.E.; Schmidt, Gregory A.

doi:10.1378/chest.10-1301

Cited by 54 publications

(53 citation statements)

References 31 publications

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“…In recent years, some investigators tried to improve the accuracy of this noninvasive method by identifying the collapse point using ultrasound, but the improvement was limited for their significant bias after comparing with the invasive measurement. 9,10 Indeed, the height of the blood column in the jugular veins that represents CVP could not be precisely quantified only if both the collapse point of IJV and the center of RA are accurately located. Thus, the key obstacle to the noninvasive CVP measurement is the failure to accurately locate the external reference point of RA in patients with different positions.…”

Section: Discussionmentioning

confidence: 99%

New Method for Noninvasive Quantification of Central Venous Pressure by Ultrasound

Xing

Liu

Zhao

et al. 2015

Circ: Cardiovascular Imaging

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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.

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Section: Discussionmentioning

confidence: 99%

New Method for Noninvasive Quantification of Central Venous Pressure by Ultrasound

Xing

Liu

Zhao

et al. 2015

Circ: Cardiovascular Imaging

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“…Bailey et al [46] reported that the simultaneously measured ratio of ≥2 for jugular veinto-common carotid artery diameter significantly correlated with a CVP of >8 mmHg in pediatric burn patients. Another investigative team found that ultrasound can be helpful in estimating jugular venous pressures [47]. However, in the latter report, both ultrasound and clinical evaluation tended to systematically underestimate the measured CVP [47].…”

Section: Overview Of Ultrasound In Hemodynamic and Volume Status Assementioning

confidence: 90%

“…Another investigative team found that ultrasound can be helpful in estimating jugular venous pressures [47]. However, in the latter report, both ultrasound and clinical evaluation tended to systematically underestimate the measured CVP [47]. Finally, Schefold et al [48] demonstrated that inspiratory and expiratory vena cava diameters correlated well with intrathoracic blood volumes, PaO2/FiO2 oxygenation index, and CVP.…”

Section: Overview Of Ultrasound In Hemodynamic and Volume Status Assementioning

confidence: 97%

Clinician-performed ultrasound in hemodynamic and cardiac assessment: a synopsis of current indications and limitations

Kelly

Esteve

Papadimos

et al. 2015

Eur J Trauma Emerg Surg

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Accurate hemodynamic and intravascular volume status assessment is essential in the diagnostic and therapeutic management of critically ill patients. Over the last two decades, a number of technological advances were translated into a variety of minimally invasive or non-invasive hemodynamic monitoring modalities. Despite the promise of less invasive technologies, the quality, reliability, reproducibility, and generalizability of resultant hemodynamic and intravascular volume status data have been lacking. Since its formal introduction, ultrasound technology has provided the medical community with a more standardized, higher quality, broadly applicable, and reproducible method of accomplishing the above-mentioned objectives. With the advent of portable, hand-carried devices, the importance of sonography in hemodynamic and volume status assessment became clear. From basic venous collapsibility and global cardiac assessment to more complex tasks such as the assessment of cardiac flow and tissue Doppler signals, the number of real-life indications for sonology continues to increase. This review will provide an outline of the essential ultrasound applications in hemodynamic and volume status assessment, focusing on evidence-based uses and indications.

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“…This finding correlates well with the CVP, although it tends to slightly underestimate the CVP. 7 In our experience, this is less subjective than attempting to discern the JVP by traditional examination.…”

Section: How Can a Clinician Confidently Estimate Cvp If The Ivc Cannmentioning

confidence: 98%

Bedside Ultrasonography Evaluation of Shock

Farkas

Anawati

2015

Hospital Medicine Clinics

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Ultrasound Accurately Reflects the Jugular Venous Examination but Underestimates Central Venous Pressure

Cited by 54 publications

References 31 publications

New Method for Noninvasive Quantification of Central Venous Pressure by Ultrasound

New Method for Noninvasive Quantification of Central Venous Pressure by Ultrasound

Clinician-performed ultrasound in hemodynamic and cardiac assessment: a synopsis of current indications and limitations

Bedside Ultrasonography Evaluation of Shock

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