Could internal jugular vein ultrasound be useful in the assessment of patients with heart failure? A systematic review

Abstract

Many recent studies have validated the internal jugular vein ultrasound (IJV-US) ultrasound for estimating volemic status in critical patients. If research confirms its accuracy in detecting intravascular volume, congestion, and prognosis, this method could help manage heart failure (HF) because it is simple, fast, and applicable in several settings. This review examines the IJV-US’s reliability, diagnostic accuracy, and ability to predict poor outcomes for HF, as well as its correlation with surrogate congestion tests like natriuretic peptides and elevated central venous pressure (CVP). Our systematic review followed the PRISMA statement for systematic reviews and meta-analyses. Eleven studies examined the reliability and validity of IJV-US measures in predicting congestion, volume status, and prognosis in adult spontaneously breathing HF patients. We searched PubMed, Cochrane Library, and EMBASE. IJV-US measurements using Valsalva and sniffing seem more accurate for predicting congestion, volume status, high CVP, and poor prognosis. The IJV ratio in chronic HF and out-hospital patients and the absence of IJV area [cross-sectional area (CSA)] changes in acute HF (AHF) and in-hospital patients are the most validated measurements. No evidence suggests the method is reliable between and within raters. AHF patients’ IJV ratio and CSA absence appear to correlate with CVP and atrial natriuretic peptides. In conclusion, the IJV-US may be useful for managing HF patients, but more research is needed to confirm its reliability and prognostic accuracy. Develop a standard US protocol lastly.