New method for noninvasive quantification of central venous pressure by ultrasound

Circ Cardiovasc Imaging. 2015 May;8(5):e003085. doi: 10.1161/CIRCIMAGING.114.003085.

Abstract

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.

Keywords: central venous pressure; ultrasonography.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Blood Pressure Determination / methods*
  • Catheterization, Central Venous
  • Central Venous Pressure / physiology*
  • Echocardiography
  • Feasibility Studies
  • Female
  • Heart Atria / diagnostic imaging
  • Hemodynamics
  • Humans
  • Imaging, Three-Dimensional
  • Jugular Veins / diagnostic imaging
  • Male
  • Middle Aged
  • Monitoring, Intraoperative
  • Radiographic Image Interpretation, Computer-Assisted
  • Reproducibility of Results
  • Tomography, X-Ray Computed