title: The sensitivity and specificity of ultrasound estimation of central venous pressure using the internal jugular vein.
abstract: OBJECTIVE
  The fluid volume status of a patient is difficult to assess clinically. The aim of this study was to compare the ultrasound estimation of the height of the right internal jugular vein (CVP(IJV)) with direct estimation of central venous pressure (CVP) (CVP(CVC)).
  
  
  METHODS
  A portable ultrasound machine defined the "top" of the right internal jugular vein in 44 patients from a single tertiary hospital. The vertical height from this point to the sternal angle was used to estimate CVP(IJV). A central venous catheter was then inserted and direct measurement of CVP was made with a pressure transducer. A normal CVP was defined as 3 to 6 mm Hg.
  
  
  RESULTS
  For overloaded patients, CVP(IJV) correlated well with CVP(CVC), P = .004, sensitivity of 64.3%, specificity of 81.3%, and positive predictive value of 85.7%. The area under the curve for the receiver operating characteristic curve was 0.73 (95% confidence interval, 0.59-0.86). For undervolumed patients, the correlation remained statistically significant, P < .001, sensitivity of 88.9%, specificity of 77.1%, and negative predictive value of 96.4%. The area under the curve was 0.83 (95% confidence interval, 0.70-0.96).
  
  
  CONCLUSIONS
  Ultrasound estimation of CVP using a portable ultrasound machine and the internal jugular vein is simple, noninvasive, and accurate.
authors.affiliation: Department of Renal Medicine, Fremantle Hospital, Fremantle, WA, Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: Siva
authors.forename: Austin
authors.initials: A
authors.lastname: Hunt
authors.forename: Neil
authors.initials: N
authors.lastname: Boudville
mesh_terms: D001795:Blood Pressure Determination / Q000379:methods*; D002405:Catheterization, Central Venous; D002496:Central Venous Pressure; D005260:Female; D006801:Humans; D020896:Hypovolemia / Q000175:diagnosis; D007362:Intensive Care Units; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography