Comparison of noninvasive central venous pressure measurement methods

It is crucial to determine intravascular volume status in management of critically ill patients. In our study, we aimed to compare noninvasive ultrasonographic central venous pressure measurement methods of measurement of inspiratory and expiratory diameters, area and height of internal jugular vein, inspiratory and expiratory diameters and collapsibility index of vena cava inferior, early systolic and early diastolic flow velocities of tricuspid valve and fractional shortening of right ventricle outflow tract diameters. We hypothesized that data obtained from bedside measurements may be used as a surrogate of invasive central venous pressure. Our study has been conducted between January 2015-January 2016 on 81 patients who were over the age of 18 and to whom a central venous catheter has been placed into subclavian or internal jugular vein in our Emergency Medicine Department. Inspiratory and expiratory diameters, area and height of internal jugular vein, inspiratory and expiratory diameters and collapsibility index of vena cava inferior, early systolic and early diastolic flow velocities of tricuspid valve and fractional shortening of right ventricle outflow tract diameters have been measured ultrasonographically. A noninvasive central venous presure estimation has been made by the data obtained from each method. Then, invasive central venous pressure value has been measured and made a comparison between these methods. Of all our patients, 27 of them were female (33,3%) and 54 of them were male (66,7%). The mean age was 68,58±13,33. A correlation has been found betwen inspiratory and expiratory diameters of internal jugular vein, expiratory diameter of vena cava inferior, internal jugular vein and invasive central venous pressure. We have found that ultrasonograpic, noninvasive measurement methods of internal jugular vein and inferior vena cava can be used in determining the volume status in critically ill patients.