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首页> 外文期刊>Canadian Journal of Emergency Medicine >Defining normal jugular venous pressure with ultrasonography
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Defining normal jugular venous pressure with ultrasonography

机译：超声检查确定正常的颈静脉压

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Objective:Determination of jugular venous pressure (JVP) by physical examination (E-JVP) is unreliable. Measurement of JVP with ultrasonography (U-JVP) is easy to perform, but the normal range is unknown. The objective of this study was to determine the normal range for U-JVP.Methods:We conducted a prospective anatomic study on a convenience sample of emergency department (ED) patients over 35 years of age. We excluded patients who had findings on history or physical examination suggesting an alteration of JVP. With the head of the bed at 45°, we determined the point at which the diameter of the internal jugular vein (IJV) began to decrease on ultrasonography (“the taper”). Research assistants used 2 techniques to measure U-JVP in all participants: by measuring the vertical height (in centimetres) of the taper above the sternal angle, and adding 5 cm; and by recording the quadrant in the IJV's path from the clavicle to the angle of the jaw in which the taper was located. To determine interrater reliability, separate examiners measured the U-JVP of 15 participants.Results:We successfully determined the U-JVP of all 77 participants (38 male and 39 female). The mean U-JVP was 6.35 (95% confidence interval 6.11–6.59) cm. In 76 participants (98.7%), the taper was located in the first quadrant. Determination of interrater reliability found κ values of 1.00 and 0.87 for techniques 1 and 2, respectively.Conclusion:The normal U-JVP is 6.35 cm, a value that is slightly lower than the published normal E-JVP. Interrater reliability for U-JVP is excellent. The top of the IJV column is located less than 25% of the distance from the clavicle to the angle of the jaw in the majority of healthy adults. Our findings suggest that U-JVP provides the potential to reincorporate reliable JVP measurement into clinical assessment in the ED. However, further research in this area is warranted.
机译：目的：通过体格检查（E-JVP）确定颈静脉压（JVP）是不可靠的。用超声检查（U-JVP）进行JVP的测量很容易，但是正常范围尚不清楚。本研究的目的是确定U-JVP的正常范围。方法：我们对35岁以上急诊科（ED）患者的便利性样本进行了前瞻性解剖研究。我们排除了有病史或体格检查提示JVP改变的患者。在床头为45°的情况下，我们确定了在超声检查中颈内静脉（IJV）直径开始减小的点（“锥度”）。研究助手使用了两种技术来测量所有参与者的U-JVP：测量在胸骨角上方的锥度的垂直高度（厘米），并增加5厘米;并通过记录从锁骨到锥度所在的颌骨角度的IJV路径中的象限。为了确定跨度可靠性，独立的考官对15位参与者的U-JVP进行了测量。结果：我们成功地确定了所有77位参与者（38位男性和39位女性）的U-JVP。 U-JVP的平均值为6.35（95％置信区间6.11–6.59）cm。在76位参与者（98.7％）中，锥度位于第一象限。确定间隔间可靠性时，技术1和2的κ值分别为1.00和0.87。结论：正常U-JVP为6.35 cm，该值略低于已发布的正常E-JVP。 U-JVP的评估者间可靠性很高。在大多数健康成年人中，IJV柱的顶部位于从锁骨到下颌角的距离的25％以下。我们的发现表明，U-JVP提供了将可靠的JVP测量重新纳入ED临床评估的潜力。但是，有必要对该领域进行进一步的研究。

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