scholarly journals The Oscillating Component of the Internal Jugular Vein Flow: The Overlooked Element of Cerebral Circulation

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Francesco Sisini ◽  
Eleuterio Toro ◽  
Mauro Gambaccini ◽  
Paolo Zamboni
Keyword(s):  
Pressure Gradient ◽  
Jugular Vein ◽  
Venous Pressure ◽  
Blood Velocity ◽  
Cross Sectional ◽  
Instantaneous Pressure ◽  
Cardiac Period ◽  
Venous Pulse ◽  
The Brain ◽  
Cardiac Haemodynamics

The jugular venous pulse (JVP) provides valuable information about cardiac haemodynamics and filling pressures and is an indirect estimate of the central venous pressure (CVP). Recently it has been proven that JVP can be obtained by measuring the cross-sectional area (CSA) of the IJV on each sonogram of an ultrasound B-mode sonogram sequence. It has also been proven that during its pulsation the IJV is distended and hence that the pressure gradient drives the IJV haemodynamics. If this is true, then it will imply the following: (i) the blood velocity in the IJV is a periodic function of the time with period equal to the cardiac period and (ii) the instantaneous blood velocity is given by a time function that can be derived from a flow-dynamics theory that uses the instantaneous pressure gradient as a parameter. The aim of the present study is to confirm the hypothesis that JVP regulates the IJV blood flow and that pressure waves are transmitted from the heart toward the brain through the IJV wall.

scholarly journals Excess fluid volume: clinical validation in patients with decompensated heart failure

2011 ◽  
Vol 19 (3) ◽  
pp. 540-547 ◽  
Author(s):  
Quenia Camille Soares Martins ◽  
Graziella Badin Aliti ◽  
Joelza Chisté Linhares ◽  
Eneida Rejane Rabelo
Keyword(s):  
Heart Failure ◽  
Jugular Vein ◽  
Venous Pressure ◽  
Decompensated Heart Failure ◽  
Cross Sectional Study ◽  
Fluid Volume ◽  
University Hospital ◽  
Central Venous ◽  
Cross Sectional ◽  
Nursing Diagnosis

This cross-sectional study aimed to clinically validate the defining characteristics of the Nursing Diagnosis Excess Fluid Volume in patients with decompensated heart failure. The validation model used follows the model of Fehring. The subjects were 32 patients at a university hospital in Rio Grande do Sul. The average age was 60.5 ± 14.3 years old. The defining characteristics with higher reliability index (R): R ≥ 0.80 were: dyspnea, orthopnea, edema, positive hepatojugular reflex, paroxysmal nocturnal dyspnea, pulmonary congestion and elevated central venous pressure, and minor or secondary, R> 0.50 to 0.79: weight gain, hepatomegaly, jugular vein distention, crackles, oliguria, decreased hematocrit and hemoglobin. This study indicates that the defining characteristics with R> 0.50 and 1 were validated for the diagnosis Excess Fluid Volume.

Correlation between cross-sectional area of the internal jugular vein and central venous pressure

2014 ◽  
Vol 31 (1) ◽  
pp. 50-51 ◽  
Author(s):  
Kasana Raksamani ◽  
Vachira Udompornmongkol ◽  
Suwannee Suraseranivongse ◽  
Manee Raksakietisak ◽  
Benno von Bormann
Keyword(s):  
Central Venous Pressure ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Venous Pressure ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Central Venous ◽  
Cross Sectional

scholarly journals Why Current Doppler Ultrasound Methodology Is Inaccurate in Assessing Cerebral Venous Return: The Alternative of the Ultrasonic Jugular Venous Pulse

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Paolo Zamboni
Keyword(s):  
Doppler Ultrasound ◽  
Average Velocity ◽  
Venous Return ◽  
Automatic Measurement ◽  
Cross Sectional ◽  
Time Average ◽  
Meta Analyses ◽  
Near Future ◽  
Venous Pulse ◽  
The Brain

Assessment of cerebral venous return is growing interest for potential application in clinical practice. Doppler ultrasound (DUS) was used as a screening tool. However, three meta-analyses of qualitative DUS protocol demonstrate a big heterogeneity among studies. In an attempt to improve accuracy, several authors alternatively measured the flow rate, based on the product of the time average velocity with the cross-sectional area (CSA). However, also the quantification protocols lacked of the necessary accuracy. The reasons are as follows: (a) automatic measurement of the CSA assimilates the jugular to a circle, while it is elliptical; (b) the use of just a single CSA value in a pulsatile vessel is inaccurate; (c) time average velocity assessment can be applied only in laminar flow. Finally, the tutorial describes alternative ultrasound calculation of flow based on the Womersley method, which takes into account the variation of the jugular CSA overtime. In the near future, it will be possible to synchronize the electrocardiogram with the brain inflow (carotid distension wave) and with the outflow (jugular venous pulse) in order to nicely have a noninvasive ultrasound picture of the brain-heart axis. US jugular venous pulse may have potential use in neurovascular, neurocognitive, neurosensorial, and neurodegenerative disorders.

Middle cerebral artery blood velocity during a Valsalva maneuver in the standing position

2000 ◽  
Vol 88 (5) ◽  
pp. 1545-1550 ◽  
Author(s):  
Frank Pott ◽  
Johannes J. van Lieshout ◽  
Kojiro Ide ◽  
Per Madsen ◽  
Niels H. Secher
Keyword(s):  
Cardiac Output ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Valsalva Maneuver ◽  
Venous Pressure ◽  
Standing Position ◽  
Blood Velocity ◽  
Central Venous ◽  
Mouth Pressure ◽  
The Brain

Occasionally, lifting of a heavy weight leads to dizziness and even to fainting, suggesting that, especially in the standing position, expiratory straining compromises cerebral perfusion. In 10 subjects, the middle cerebral artery mean blood velocity ( V mean) was evaluated during a Valsalva maneuver (mouth pressure 40 mmHg for 15 s) both in the supine and in the standing position. During standing, cardiac output decreased by 16 ± 4 (SE) % ( P < 0.05), and at the level of the brain mean arterial pressure (MAP) decreased from 89 ± 2 to 78 ± 3 mmHg ( P < 0.05), as did V mean from 73 ± 4 to 62 ± 5 cm/s ( P < 0.05). In both postures, the Valsalva maneuver increased central venous pressure by ∼40 mmHg with a nadir in MAP and cardiac output that was most pronounced during standing (MAP: 65 ± 6 vs. 87 ± 3 mmHg; cardiac output: 37 ± 3 vs. 57 ± 4% of the resting value; P < 0.05). Also, V mean was lowest during the standing Valsalva maneuver (39 ± 5 vs. 47 ± 4 cm/s; P < 0.05). In healthy individuals, orthostasis induces an ∼15% reduction in middle cerebral artery V mean that is exaggerated by a Valsalva maneuver performed with 40-mmHg mouth pressure to ∼50% of supine rest.

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