Internal jugular vein/common carotid artery cross-sectional area ratio and central venous pressure.

PURPOSE: To investigate the accuracy of the sonographic assessment of internal jugular vein/common carotid artery (IJV/CCA) cross-sectional area ratio in predicting central venous pressure (CVP) in critically ill patients.

METHODS: In adult patients who underwent central venous catheterization for monitoring of hemodynamic status, we used bedside sonography for diameter and cross-sectional area measurement of IJV and CCA. The IJV/CCA ratio was then calculated, and its correlation with CVP as well as its sensitivity, specificity, and positive and negative predictive values were analyzed.

RESULTS: We enrolled 52 patients with a mean age of 58.8 ± 10.7 years. The mean IJV/CCA ratio was 1.89 ± 0.83 and 1.90 ± 0.83, respectively, at inspiration and expiration. A significant correlation was observed between IJV/CCA ratio and CVP (r = 0.728, p < 0.0001 at inspiration, and r = 0.736, p < 0.0001 at expiration). Sensitivity was 90%, specificity 86.36%, positive predictive values 90%, and negative predictive values 86.36% for the prediction of CVP <10 cm H2 O.

CONCLUSIONS: Assessing the IJV/CCA ratio with a portable sonographic device could be a noninvasive alternative for central venous catheterization in order to evaluate the hemodynamic status of critically ill patients. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:312-318, 2016.