Bedside ultrasound safe and effective for detecting central venous pressure in patients of HF

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.

For further reference log on to: https://www.acpjournals.org/doi/10.7326/M21-2781