Non-Invasive Method for the Rapid Assessment of Central Venous Pressure: Description and Validation by a Single Examiner

OBJECTIVES This study describes a means of assessing the external jugular venous pressure (JVP) as an indicator of normal or elevated central venous pressure (CVP). METHODS Intensive care unit patients having CVP monitoring were examined. With patients in bed, the external jugular vein (EJV) was occluded at the base of the neck and observed to distend. The occlusion was then removed and the vein observed for collapse. Complete collapse was hypothesized to indicate a non-elevated CVP (8cm of water). RESULTS In 12 of the 40 patients examined, the EJV could not be assessed (EJV not seen at all: 5, and difficult to visualize: 7). For the remaining 28 patients 11 had a CVP > 8 cm, while 17 had a CVP patients, of </= 8. EJV assessment was 100% accurate (95% Confidence Interval 88-100) in predicting whether or not a patient's CVP was greater or less than 8 cm of water. CONCLUSION EJV assessment, when visible, is accurate to clinically assess a patient's CVP in the hands of the author. Further studies are needed to see if they are reproducible by other observer.