Non-Invasive Method for the Rapid Assessment of Central Venous Pressure: Description and Validation by a Single Examiner
Objectives: This study describes a means of assessing the external jugular venous pressure (JVP) as an indicator of normal or elevated central venous pressure (CVP).Methods: Intensive care unit patients having CVP monitoring were examined. With patients in bed, the external jugular vein (EJV) was oc...
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2008-11-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/8c31w58c |
| _version_ | 1817988121095045120 |
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| author | Zidulka, Arnold Sankoff, Jeffrey |
| author_facet | Zidulka, Arnold Sankoff, Jeffrey |
| author_sort | Zidulka, Arnold |
| collection | DOAJ |
| description | Objectives: This study describes a means of assessing the external jugular venous pressure (JVP) as an indicator of normal or elevated central venous pressure (CVP).Methods: Intensive care unit patients having CVP monitoring were examined. With patients in bed, the external jugular vein (EJV) was occluded at the base of the neck and observed to distend. The occlusion was then removed and the vein observed for collapse. Complete collapse was hypothesized to indicate a non-elevated CVP (≤8cm of water). In those patients whose EJV collapsed incompletely, the vein was then occluded with the finger near the angle of the jaw. With the occlusion maintained, the vein was milked downwards with the other hand to cause its emptying and was then observed for filling from below. Filling from below was hypothesized to indicate an elevated CVP (>8cm of water).Results: In 12 of the 40 patients examined, the EJV could not be assessed (EJV not seen at all: 5, and difficult to visualize: 7). For the remaining 28 patients, 11 had a CVP > 8 cm, while 17 had a CVP of < 8. EJV assessment was 100% accurate (95% Confidence Interval 88-100) in predicting whether or not a patient’s CVP was greater or less than 8 cm of water.Conclusion: EJV assessment, when visible, is accurate to clinically assess a patient’s CVP in the hands of the author. Further studies are needed to see if they are reproducible by other observer.[WestJEM. 2008;9:201-205.] |
| first_indexed | 2024-04-14T00:30:20Z |
| format | Article |
| id | doaj.art-70bface20ca4490c99a9fad769d7a325 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-04-14T00:30:20Z |
| publishDate | 2008-11-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-70bface20ca4490c99a9fad769d7a3252022-12-22T02:22:33ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182008-11-0194201205Non-Invasive Method for the Rapid Assessment of Central Venous Pressure: Description and Validation by a Single ExaminerZidulka, ArnoldSankoff, JeffreyObjectives: This study describes a means of assessing the external jugular venous pressure (JVP) as an indicator of normal or elevated central venous pressure (CVP).Methods: Intensive care unit patients having CVP monitoring were examined. With patients in bed, the external jugular vein (EJV) was occluded at the base of the neck and observed to distend. The occlusion was then removed and the vein observed for collapse. Complete collapse was hypothesized to indicate a non-elevated CVP (≤8cm of water). In those patients whose EJV collapsed incompletely, the vein was then occluded with the finger near the angle of the jaw. With the occlusion maintained, the vein was milked downwards with the other hand to cause its emptying and was then observed for filling from below. Filling from below was hypothesized to indicate an elevated CVP (>8cm of water).Results: In 12 of the 40 patients examined, the EJV could not be assessed (EJV not seen at all: 5, and difficult to visualize: 7). For the remaining 28 patients, 11 had a CVP > 8 cm, while 17 had a CVP of < 8. EJV assessment was 100% accurate (95% Confidence Interval 88-100) in predicting whether or not a patient’s CVP was greater or less than 8 cm of water.Conclusion: EJV assessment, when visible, is accurate to clinically assess a patient’s CVP in the hands of the author. Further studies are needed to see if they are reproducible by other observer.[WestJEM. 2008;9:201-205.]http://escholarship.org/uc/item/8c31w58cCVPphysical exam |
| spellingShingle | Zidulka, Arnold Sankoff, Jeffrey Non-Invasive Method for the Rapid Assessment of Central Venous Pressure: Description and Validation by a Single Examiner Western Journal of Emergency Medicine CVP physical exam |
| title | Non-Invasive Method for the Rapid Assessment of Central Venous Pressure: Description and Validation by a Single Examiner |
| title_full | Non-Invasive Method for the Rapid Assessment of Central Venous Pressure: Description and Validation by a Single Examiner |
| title_fullStr | Non-Invasive Method for the Rapid Assessment of Central Venous Pressure: Description and Validation by a Single Examiner |
| title_full_unstemmed | Non-Invasive Method for the Rapid Assessment of Central Venous Pressure: Description and Validation by a Single Examiner |
| title_short | Non-Invasive Method for the Rapid Assessment of Central Venous Pressure: Description and Validation by a Single Examiner |
| title_sort | non invasive method for the rapid assessment of central venous pressure description and validation by a single examiner |
| topic | CVP physical exam |
| url | http://escholarship.org/uc/item/8c31w58c |
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