Is external jugular venous pressure a good predictor of volume status in kidney graft recipients?

To ensure appropriate function of the transplanted organ, it is necessary to adequately maintain vascular volume during the kidney transplantation procedure. For this purpose, central venous pressure (CVP) is monitored through a catheter inserted into the superior vena cava (SVC). Central venous cannulation is associated with a risk of serious complications. An objective of this study was to investigate whether there was a correlation between pressures measured in the SVC and in the external jugular vein (EJV). We studied 33 chronically dialyzed patients who had a short catheter placed in the EJV because of difficulties in peripheral vein cannulation in the limbs. In each case, general anesthesia was induced and a central catheter inserted into the SVC. Every 10 minutes venous pressure measurements were obtained simultaneously at both sites. A significant (P < .001) correlation was observed between external jugular vein pressure (EJVP) and CVP. CVP could be described as a function of EJVP by the equation CVP = {0.90299 x EJVP} - 0.8361. The results of this study indicated that monitoring the EJVP allows equally efficient evaluation of vascular volume as the CVP. In our opinion, EJVP is sufficient to evaluate vascular volume during kidney transplantation in patients with difficult vascular access.