Can non-invasive ventilation modify central venous pressure? Comparison between invasive measurement and ultrasonographic evaluation

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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Haemodynamic Monitoring in Theatre

British Journal of Anaesthetic and Recovery Nursing ◽

10.1017/s1742645600002114 ◽

2003 ◽

Vol 4 (1) ◽

pp. 10-16 ◽

Cited By ~ 1

Author(s):

Heidi Clinton

Keyword(s):

Blood Pressure ◽

Pulmonary Artery ◽

Central Venous Pressure ◽

Venous Pressure ◽

Haemodynamic Monitoring ◽

Pressure Monitoring ◽

Central Venous ◽

Noninvasive Measurements ◽

Non Invasive ◽

Arterial Blood

AbstractThe number of devices available to monitor the haemodynamic status of patients is increasing. Practitioners need to be aware of the non-invasive and invasive methods available in order to care for their patients safely and effectively. This article reviews a number of noninvasive measurements of haemodynamic function, in addition to invasive methods such as arterial blood pressure, central venous pressure and pulmonary artery pressure monitoring. It is argued that using these methods in combination provides a comprehensive haemodynamic assessment.

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Pulse Transit Time Allows A Reliable Non-Invasive Measurement Of Respiratory Effort Under Non-Invasive Ventilation

10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a3113 ◽

2012 ◽

Author(s):

Olivier Contal ◽

Claudio Carnevale ◽

Jean-Christian Borel ◽

Abdelkebir Sabil ◽

Renaud Tamisier ◽

...

Keyword(s):

Transit Time ◽

Pulse Transit Time ◽

Respiratory Effort ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Invasive Measurement

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P056: Non-invasive measurement of the central venous pressure using near-infrared spectroscopy versus point-of-care ultrasound

CJEM ◽

10.1017/cem.2018.254 ◽

2018 ◽

Vol 20 (S1) ◽

pp. S76-S77

Author(s):

N. Goumeniouk ◽

J. Newbigging ◽

M. McDonnell ◽

M.L.A. Sivilotti

Keyword(s):

Emergency Department ◽

Infrared Spectroscopy ◽

Near Infrared ◽

Point Of Care ◽

Venous Pressure ◽

Point Of Care Ultrasound ◽

Central Venous ◽

Non Invasive ◽

Secondary Outcomes ◽

Invasive Measurement

Introduction: A fundamental hemodynamic parameter, the central venous pressure (CVP) is rarely available in the emergency patient due the delay and risks inherent to central vein cannulation. Recently, two non-invasive strategies have emerged: a) point-of-care ultrasound to supplement traditional inspection the internal jugular waveform ; or b) near-infrared spectroscopy (NIRS) of the external jugular vein. Methods: Five medical students underwent standardized training on both NIRS device (Venus 2000 CVP; Mespere Life Sciences, Waterloo ON) and ultrasound-assisted CVP assessment. During prescheduled, randomly permuted and balanced shifts, a pair of students obtained blinded independent measurements using each device within 10 minutes of each other. High priority subjects likely to have abnormal CVP (e.g. vomiting, dehydrated, heart failure, sepsis) were approached preferentially, followed by a convenience sample of other eligible patients in the emergency department. Secondary outcomes were stopwatch-recorded time from device ready to stable measurement, as well as operator ease, operator confidence and patient discomfort. The blinded treating physician rated each subjects volume status on an ordered scale: depleted, neutral and overloaded. Results: We enrolled 104 patients (median [IQR] age 68 [53, 78] years; 50% male; BMI 27.6 [17.0, 47.7] kg/m2; admission rate 27%) in June-August 2017. Treating physicians classified 17 as volume depleted and 12 overloaded. CVP measurements differed widely between techniques: ultrasound 8 [7, 9] cmH2O (3 cases unobtainable) vs NIRS 12 [8, 17] cmH2O (13 unobtainable). Agreement and correlation between the two devices was extremely low (R2=0.04). While neither technique demonstrated a strong association with the treating physicians estimate of volume status, only the ultrasound values increased monotonically with physician estimate. With regards to secondary outcomes, ultrasound measurements took less time (paired difference 50 seconds [95% CI 7, 93]), and operators were more confident (0.63 [0.02, 1.23] out of 10) and at ease (0.78, [0.13, 1.43]) with ultrasound; patients rated discomfort equally (-0.06 [-0.30, 0.18]). Conclusion: Non-invasive measurement of CVP remains a challenge in the emergency department. The external jugular pressure by NIRS has very high variability and poor agreement with ultrasound-enhanced inspection of the internal jugular, suggesting that this technique is not yet practical for use by non-experts.

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