Internal jugular vein/common carotid artery cross-sectional area ratio and central venous pressure

Abstract Background Assessment of the central venous pressure (CVP) is an essential hemodynamic parameter for monitoring the dialyzing patients. Our objective of the present study is to investigate the accuracy of CVP measurement by internal jugular vein US in comparison to the direct measurement by the central venous catheters for hemodialysis patients. We included 106 patients; where their CVP was assessed in two different non invasive US methods (CVPni) separately and in combination and the obtained measurements were correlated to the invasive measurements (CVPi) by catheters. Results By method 1, there is a highly significant positive correlation between CVPni and CVPi (ρ < 0.001) and a Pearson correlation coefficient (r = 0.913 n = 93), and by method 2, there is also a highly significant positive correlation between the CVPni and CVPi in both groups (r = 0.832, 95%, n = 106, p < 0.001), 1.935 was the cut-off point for prediction of CVP ≥ 10cmH20. For differentiation between patients with CVP < 10cmH20 and ≥ 10cmH20, the accuracy measures (sensitivity, specificity, PPV, NPV, and overall accuracy) were 100%, 79.31%, 74.47%, 100%, and 87.10% by method 1, and were 91.11%, 85.48%, 82.00%, 92.98%, and 87.85% by method 2, while the combination of both methods had gained 88.57%, 89.66%, 83.78%, 92.86%, and 89.25%, respectively. Conclusion The US offered a reliable and non-invasive tool for monitoring CVP. The present study has a novelty of combining more than one US method and this had reported higher accuracy measures and outperformed the use of a single method.

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The Relation Between Common Carotid Artery Diameter and Central Venous Pressure for Assessment of Intravascular Fluid Status after Major Surgeries; an Observational Study

Anesthesiology and Pain Medicine ◽

10.5812/aapm.105138 ◽

2020 ◽

Vol 10 (4) ◽

Author(s):

Samaa A Kasem Rashwan ◽

Ashraf Abd Elmawgood Bassiouny ◽

Ahmed A Badawy ◽

Ahmed Rabea Mohammed

Keyword(s):

Carotid Artery ◽

Central Venous Pressure ◽

Common Carotid Artery ◽

Venous Pressure ◽

Fluid Challenge ◽

Fluid Administration ◽

Adult Patients ◽

P Value ◽

Central Venous ◽

Spontaneously Breathing

Objectives: The current study aimed to find the relation between the changes in the common carotid artery (CCA) diameter and the central venous pressure (CVP) in response to a fluid challenge in spontaneously breathing adult patients. Methods: This study included 65 adult patients aged 20 - 60 years who were admitted to the surgical ICU. The CCA diameter and CVP were measured before and after fluid challenge, and the percentage of increase in the CCA diameter and CVP were calculated. The correlation was assessed between changes in the CVP and CCA diameter. Results: The CCA diameter before fluid administration had a significant strong positive correlation to the CVP (r = 0.8, P value < 0.001); the increase in the CCA diameter after fluid administration had a significant moderate positive correlation with the increase in the CVP (r = 0.4, P value < 0.001). The percentage of increase in CCA diameters was positively correlated to the percentage of increase in CVP (r = 0.589, P value = 0.001) following fluid administration. However, the Receiver Operating Characteristic (ROC) analysis was an invalid test (area under curve 0.513, P value = 0.885). Conclusions: After major surgeries, the change in the CCA diameter was positively correlated with the change in the CVP values in response to fluid administration in the spontaneously breathing adult patients, but the cut-off limit cannot be reached.

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