Journal article
Ultrasound Accurately Reflects the Jugular Venous Examination but Underestimates Central Venous Pressure
Chest, Vol.139(1), pp.95-100
2011
DOI: 10.1378/chest.10-1301
PMID: 20798190
Abstract
Background: Bedside ultrasound examination could be used to assess jugular venous pressure (JVP), and thus central venous pressure (CVP), more reliably than clinical examination. Methods: The study was a prospective, blinded evaluation comparing physical examination of external jugular venous pressure (JVPEXT), internal jugular venous pressure (JVPINT), and ultrasound collapse pressure (UCP) with CVP measured using an indwelling catheter. We compared the examination of the external and internal JVP with each other and with the UCP and CVP. JVPEXT, JVPINT, UCP, and CVP were compared graphically using Bland-Altman plots, and correlation coefficients were calculated. Results: The correlation coefficients comparing CVP to UCP, JVPEXT, and JVPINT were 0.62, 0.57, and 0.50, respectively. When UCP was compared with JVPEXT and JVPINT, correlation coefficients were 0.91 and 0.81, respectively. Last, the correlation coefficient comparing JVPEXT and JVPINT was 0.98. The Bland-Altman graphical comparison of methods technique revealed that CVP was often underestimated by UCP, and clinical examination of JVPEXT and JVPINT. In contrast, there was no systematic bias between UCP and either JVPEXT or JVPINT, nor between JVPEXT and JVPINT. Conclusions: Ultrasound examination is capable of measuring accurately the JVP as judged from the internal or external jugular vein. However, like the JVP, ultrasound typically underestimates CVP. A systematic bias between UCP and CVP suggests the presence of a variable degree of venous tone, possibly signaling contraction of jugular venous smooth muscle.
Details
- Title: Subtitle
- Ultrasound Accurately Reflects the Jugular Venous Examination but Underestimates Central Venous Pressure
- Creators
- Gur Raj Deol - Department of Internal Medicine, University of Iowa, Iowa City, IA, United StatesNicole COLLETT - Department of Internal Medicine, University of Iowa, Iowa City, IA, United StatesAndrew ASHBY - Department of Internal Medicine, University of Iowa, Iowa City, IA, United StatesGregory A SCHMIDT - Department of Internal Medicine, University of Iowa, Iowa City, IA, United States
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.139(1), pp.95-100
- Publisher
- American College of Chest Physicians
- DOI
- 10.1378/chest.10-1301
- PMID
- 20798190
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Grant note
- name: the University of Iowa institutional review board, award: (ID number 200706777)
- Language
- English
- Date published
- 2011
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984094628802771
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