Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jun 26, 2024; 16(6): 310-313
Published online Jun 26, 2024. doi: 10.4330/wjc.v16.i6.310
Ultrasound based estimate of central venous pressure: Are we any closer?
Atit A Gawalkar, Akash Batta
Atit A Gawalkar, Department of Cardiology, Fortis Hospital, Himachal Pradesh, Kangra 176001, India
Akash Batta, Department of Cardiology, Dayanand Medical College and Hospital, Punjab, Ludhiana 141001, India
Author contributions: Batta A contributed to the conception and design, approved the manuscript, and took overall responsibility; Batta A and Gawalkar AA wrote and critically revised the manuscript. All authors have read and approved of the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akash Batta, MD, Assistant Professor, Senior Scientist, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Punjab, Ludhiana 141001, India. akashbatta02@gmail.com
Received: February 11, 2024
Revised: May 1, 2024
Accepted: May 22, 2024
Published online: June 26, 2024
Processing time: 134 Days and 20.3 Hours
Abstract

Central venous pressure (CVP) serves as a direct approximation of right atrial pressure and is influenced by factors like total blood volume, venous compliance, cardiac output, and orthostasis. Normal CVP falls within 8-12 mmHg but varies with volume status and venous compliance. Monitoring and managing disturbances in CVP are vital in patients with circulatory shock or fluid disturbances. Elevated CVP can lead to fluid accumulation in the interstitial space, impairing venous return and reducing cardiac preload. While pulmonary artery catheterization and central venous catheter obtained measurements are considered to be more accurate, they carry risk of complications and their usage has not shown clinical improvement. Ultrasound-based assessment of the internal jugular vein (IJV) offers real-time, non-invasive measurement of static and dynamic parameters for estimating CVP. IJV parameters, including diameter and ratio, has demonstrated good correlation with CVP. Despite significant advancements in non-invasive CVP measurement, a reliable tool is yet to be found. Present methods can offer reasonable guidance in assessing CVP, provided their limitations are acknowledged.

Keywords: Central venous pressure; Internal jugular vein; Point of care ultrasound; Shock; Volume status; Fluid balance

Core Tip: Central venous pressure (CVP) serves as a direct approximation of right atrial pressure and is influenced by factors like total blood volume, venous compliance, cardiac output, and orthostasis. Normal CVP falls within 8-12 mmHg but varies with volume status and venous compliance. Monitoring and managing disturbances in CVP are vital in patients with circulatory shock or fluid disturbances. Despite significant advancements in non-invasive CVP measurement, a reliable tool is yet to be found. Present methods can offer reasonable guidance in assessing CVP, provided their limitations are acknowledged.