Donahue Sean P, Wood Joseph P, Patel Bhavesh M, Quinn James V
Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, California, USA.
Am J Emerg Med. 2009 Sep;27(7):851-5. doi: 10.1016/j.ajem.2008.06.005.
Determination of volume status is crucial in treating acutely ill patients. This study examined bedside ultrasonography of the internal jugular vein (IJV) to predict central venous pressure (CVP). Ultrasonography was performed on 34 nonventilated patients with monitored CVPs. The IJV was measured during the respiratory cycle and with the patient in different positions. Mean IJV diameter in patients with CVP less than 10 cm H2O was 7.0 mm (95% confidence interval [CI], 5.7-8.3) vs 12.5 mm (95% CI, 11.2-13.8) in patients with CVP of 10 cm H2O and greater. Measurement of end expiratory diameter with the patient supine had the highest correlation coefficient: 0.82 (95% CI). There was strong agreement among ultrasonographers: correlation coefficient, 0.92 (95% CI). This pilot study shows promise that ultrasonography of the IJV can be a noninvasive tool to predict CVP. Measurement of end expiratory diameter in supine patients exhibited a high correlation to CVP.
确定容量状态对于治疗急重症患者至关重要。本研究检查了颈内静脉（IJV）的床旁超声检查以预测中心静脉压（CVP）。对34例监测CVP的非通气患者进行了超声检查。在呼吸周期中以及患者处于不同体位时测量IJV。CVP小于10 cm H2O的患者平均IJV直径为7.0 mm（95%置信区间[CI]，5.7 - 8.3），而CVP为10 cm H2O及以上的患者为12.5 mm（95% CI，11.2 - 13.8）。患者仰卧位时测量呼气末直径的相关系数最高：0.82（95% CI）。超声检查人员之间有很强的一致性：相关系数为0.92（95% CI）。这项初步研究表明，IJV超声检查有望成为预测CVP的非侵入性工具。仰卧位患者呼气末直径的测量与CVP高度相关。
