An observation study found that point-of-care ultrasonography, or POCUS, is effective for measuring jugular venous pressure (JVP) at the bedside to estimate central venous pressure (CVP) in patients with heart failure or suspected heart failure. The researchers say that while not a replacement for physical examination, formal echocardiography, or invasive hemodynamics, this procedure...
An observation study found that point-of-care ultrasonography, or POCUS, is effective for measuring jugular venous pressure (JVP) at the bedside to estimate central venous pressure (CVP) in patients with heart failure or suspected heart failure.
The researchers say that while not a replacement for physical examination, formal echocardiography, or invasive hemodynamics, this procedure demonstrates accuracy and reproducibility in clinical applications. The findings have been published in Annals of Internal Medicine.
There has been a significant increase in the uptake of point-of-care ultrasound (POCUS) in the UK over the last two decades. The advent of smaller, more portable machines combined with improved picture quality has brought ultrasound out of the radiology department and onto the wards.
Accurately estimating central venous pressure (CVP) is critical to the diagnosis and management of heart failure, but traditional examination techniques to determine central venous pressure (CVP) are increasingly unreliable because of technical limitations and changing patient populations.
Researchers from the University of Utah School of Medicine studied a convenience sample of 100 patients undergoing right heart catheterization with both reduced and preserved ejection fraction to validate the accuracy of quantitative and qualitative POCUS assessment of jugular venous pressure (JVP) in predicting elevated central venous pressure (CVP). For each of the participants, jugular venous pressure (JVP) height was estimated by handheld ultrasound device (uJVP), JVP was measured by traditional physical examination, and qualitative presence of a distended uJVP in the upright position (upright-uJVP) was done before invasive measurements. Receiver-operating characteristic analysis of the uJVP was compared with invasive hemodynamics. The researchers found that quantitative and qualitative uJVP accurately predicts elevated right atrial pressure. Additionally, visualization of the uJVP was possible in 100% of those enrolled, whereas visualization of the traditional jugular venous pressure (JVP) was possible in only 42 of the 69 patients examined. According to the authors, these findings show that traditional and familiar jugular venous pressure (JVP) examination can be enhanced by hand held-ultrasound examination.
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