Ultrasonographic assessment of the internal jugular vein for the estimation of central venous pressure in hemodialysis patients: A preliminary study.

ABSTRACT

PURPOSE: To investigate a new noninvasive method to assess central venous pressure (CVP) in hemodialysis patients, based on the ultrasonographic measurement of the collapsing point of the internal jugular vein (CVPni). MATERIALS AND METHODS: In this preliminary, noninterventional, single center study, we enrolled 22 dialyzed patients with an indwelling jugular catheter. CVPni was compared to the gold-standard invasive measurement of CVP using the central venous catheter (CVPi). Agreement between CVPi and CVPni was assessed by Bland and Altman Method. Correlation was assessed by linear regression. RESULTS: A strong correlation was observed between CVPi and CVPni (OR = 3.47 [2.96; 4.07], P < .0001). For overloaded patients, the area under the curve for the operating characteristic curve was 0.971 (IC95 0.915; 1.000). For under-loaded patients, area under the curve was 0.971 (IC95 0.917; 1.000). The mean bias between intra-individual CVPi and CVPni measures was 0.57 cm H2 O (SD 3.1 cm H2 O). CONCLUSION: CVPni appears as a noninvasive and reliable technique. Further studies are required to confirm these results and to assess the direct clinical impact of this new method.