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Prospects of jugular venous pulse assessment.
MedLine Citation:
PMID:  22049834     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
There is no controversy regarding the current clinical method of examination of waveform of jugular vein pulse. However there are limitations of clinical assessment of central venous pressure by jugular vein pressure measurement from the level of sternal angle. There are variations in the reported distances from sternal angle to right atrium as well as to upper limit of JVP. In erect position, anterior end of fourth intercostal space is at about the level of mid-right atrium. In patients with visible JVP at neck in erect position, measurement of CVP can be done more accurately directly from the anterior end of fourth intercostal space. For others, the position of mid-right atrium can be marked in lateral chest wall first in erect position at the mid-point of an anteroposterior line from anterior end of fourth intercostal space to back. Subsequently in reclining position, the vertical height of venous pressure can be measured from the horizontal plane of the midpoint marked at lateral chest wall to visible upper limit of JVP. Such measurement can be done in a more reliable way with venous pressure (VP) manometer with its indicator rod at the horizontal plane of mid-right atrium and with its horizontal surface at upper limit of JVP. The venous pressure manometer can also be used to measure relatively less reliable upper limb venous pressure (ULVP), as indicated by the vertical distance at which veins of upper limb collapse, especially when JVP is not visualized due to subnormal CVP as in hypovolemia.
Authors:
M D Bhattarai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JNMA; journal of the Nepal Medical Association     Volume:  49     ISSN:  0028-2715     ISO Abbreviation:  JNMA J Nepal Med Assoc     Publication Date:    2010 Jul-Sep
Date Detail:
Created Date:  2011-11-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0045233     Medline TA:  JNMA J Nepal Med Assoc     Country:  Nepal    
Other Details:
Languages:  eng     Pagination:  247-54     Citation Subset:  IM    
Affiliation:
General Medicine Unit with Diabetes and Endocrinology Service, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. mdb@ntc.net.np
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