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Defining normal jugular venous pressure with ultrasonography.
Steven J Socransky1, Ray Wiss, Ron Robins
1Emergency Department, Hôpital regional de Sudbury Regional Hospital, Northern Ontario Medical School of Medicine, 700 Paris St., Sudbury, Ontario, Canada. ssocransky@hrsrh.on.ca
CJEM
|July 24, 2010
Summary
Ultrasonography offers a reliable method for measuring jugular venous pressure (JVP). The normal range for ultrasound-measured JVP (U-JVP) in adults is 6.35 cm, with excellent interrater reliability.
Area of Science:
- Emergency Medicine
- Diagnostic Imaging
- Cardiovascular Physiology
Background:
- Physical examination for jugular venous pressure (JVP) is often unreliable.
- Ultrasonography provides an accessible method for JVP measurement (U-JVP), but its normal range is not established.
Purpose of the Study:
- To determine the normal range for ultrasound-measured jugular venous pressure (U-JVP).
- To assess the reliability of U-JVP measurement techniques.
Main Methods:
- Prospective study of 77 adult emergency department patients without conditions affecting JVP.
- U-JVP measured using two techniques: vertical height of the internal jugular vein (IJV) taper and location of the taper.
- Interrater reliability assessed on 15 participants.
Main Results:
- The mean U-JVP was determined to be 6.35 cm (95% CI: 6.11-6.59).
- The IJV taper was located in the first quadrant in 98.7% of participants.
- Excellent interrater reliability was found for both measurement techniques (kappa values 1.00 and 0.87).
Conclusions:
- The normal U-JVP is established at 6.35 cm, slightly lower than traditional physical exam values.
- U-JVP measurement demonstrates excellent reliability and can potentially enhance clinical assessment in the emergency department.
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