COMPARISON OF NONINVASIVE CENTRAL VENOUS PRESSURE MEASUREMENT METHODS: INTERNAL JUGULAR VEIN VERSUS VENA CAVA INFERIOR

Abstract

Objective
 Central venous pressure measurement is an effective
 method to detect the volume status of the patients.
 However, life-threatening complications such as
 pneumothorax may occur. We assume that ultrasonographic
 measurements may be used as a surrogate
 of invasive central venous pressure.
 Materials and Methods
 Our study has been conducted between January
 2015-January 2016 on 81 patients who were over
 the age of 18 and to whom a central venous catheter
 has been placed in the internal jugular vein (IJV)
 in our Emergency Intensive Care Unit. The height of
 the blood column in the internal jugular vein, internal
 jugular vein collapsibility index (IJV-CI) and the caval
 index (CI) of vena cava inferior have been measured
 by ultrasound. Then, invasive central venous pressure
 (CVP) has been measured and the patients were
 separated into two groups as low CVP and normal
 CVP groups and statistically significance was sought
 between groups in regard of these three methods.
 Results
 The mean age was 68.58±13.33 years. Fifty-four of
 the patients (66.6%) were male. Forty-six patients
 (56.8%) were mechanically ventilated. Low CVP
 group consisted of 62 patients (76.5%). Mean invasive
 CVP was 4.83±4.26 mmHg. There were significant
 correlations between IJV-CI and invasive CVP along
 with the CI (r=-0.267, p=0.016 and r=0.319, p=0.04,
 respectively), IJV height method and CI as well as
 invasive CVP measurement (r=-0.231, p=0.03 and
 r=0.357, p=0.01, respectively). The CI did not yield
 any correlation between invasive CVP measurement
 (r=-0.010, p=0.368).
 Conclusion
 Noninvasive central venous pressure measurement
 methods may be used as a surrogate for invasive
 central venous pressure levels. The IJV-CI may be
 a useful tool to estimate CVP. Measurements of IJV
 yields better results than the measurements from
 vena cava inferior (VCI) especially in volume depleted
 patients.