Document Detail


Ultrasound accurately reflects the jugular venous examination but underestimates central venous pressure.
MedLine Citation:
PMID:  20798190     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01099241; URL: clinicaltrials.gov.
Authors:
Gur Raj Deol; Nicole Collett; Andrew Ashby; Gregory A Schmidt
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2010-08-26
Journal Detail:
Title:  Chest     Volume:  139     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-06     Completed Date:  2011-04-05     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  95-100     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Iowa, 200 Hawkins Dr, C33-GH, Iowa City, IA 52242, USA.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01099241
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MeSH Terms
Descriptor/Qualifier:
Central Venous Pressure*
Critical Illness
Female
Humans
Jugular Veins / physiology,  ultrasonography*
Male
Middle Aged
Prospective Studies
Reproducibility of Results

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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