The sensitivity and specificity of ultrasound estimation of central venous pressure using the internal jugular vein

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• 作者：Brian Siva ; MBBS^a ; Austin Hunt ; MBChB ; MRCP^b ; Neil Boudville ; MBBS ; FRACP ; MMedSci^c ; ^d ; ^{neil.boudville@uwa.edu.au}
• 关键词：Central venous pressure ; Diagnostic tests ; Jugular vein ; Sensitivity and specificity ; Ultrasonography
• 刊名：Journal of Critical Care
• 出版年：2012
• 期刊代码：167_08839441
• 类别：med
• 出版时间：June, 2012
• 卷：27
• 期：3
• 页码：315.e7-315.e11
• 文件大小：332 K

摘要

Purpose

The fluid volume status of a patient is difficult to assess clinically. The aim of this study was to compare the ultrasound estimation of the height of the right internal jugular vein (CVP_IJV) with direct estimation of central venous pressure (CVP) (CVP_CVC).

Materials and Methods

A portable ultrasound machine defined the 鈥渢op鈥?of the right internal jugular vein in 44 patients from a single tertiary hospital. The vertical height from this point to the sternal angle was used to estimate CVP_IJV. A central venous catheter was then inserted and direct measurement of CVP was made with a pressure transducer. A normal CVP was defined as 3 to 6 mm Hg.

Results

For overloaded patients, CVP_IJV correlated well with CVP_CVC, P = .004, sensitivity of 64.3%, specificity of 81.3%, and positive predictive value of 85.7%. The area under the curve for the receiver operating characteristic curve was 0.73 (95%confidence interval, 0.59-0.86). For undervolumed patients, the correlation remained statistically significant, P < .001, sensitivity of 88.9%, specificity of 77.1%, and negative predictive value of 96.4%. The area under the curve was 0.83 (95%confidence interval, 0.70-0.96).

Conclusion

Ultrasound estimation of CVP using a portable ultrasound machine and the internal jugular vein is simple, noninvasive, and accurate.