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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 k 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. Keywords: jugular veins, ultrasonography, heart failure, central venous pressure Objectif : La determination de la pression veineuse jugulaire (PVJ) par un examen physique (PVJ par examen) n'est pas fiable. La mesure de la PVJ par echographie est facile a realiser, mais la plage normale est inconnue. L'objectif de cette etude etait de determiner la plage normale pour la PVJ par echographie. Methodes : Nous avons realise une etude anatomique prospective sur un echantillon de commodite de patients de plus de 35 ans s'etant presentes a l'urgence. Nous avons exclu les patients dont les antecedents ou l'examen medical suggeraient une alteration de la PVJ. En positionnant la tete du lit a 45 degres, nous avons determine par echographie le point oU le diametre de la veine jugulaire interne (VJI) commence a se retrecir (point de retrecissement). Les assistants de recherche ont utilise deux techniques pour mesurer la PVJ par echographie chez tous les participants : 1) mesure de la hauteur verticale (en cm) du point de retrecissement audessus de l'angle sternal, plus 5 cm; 2) determination du quadrant du trajet de la VJI, de la clavicule a l'angle de la machoire oU le point de retrecissement a ete repere. Differents examinateurs ont mesure la PVJ par echographie de 15 participants pour determiner la fiabilite inter-evaluateurs. Resultats : Nous avons mesure avec succes la PVJ par echographie chez tous les participants (77, dont 38 hommes et 39 femmes). La valeur moyenne de la PVJ par echographie etait de 6,35 cm (intervalle de confiance [IC] de 95 %, de 6,11 a 6,59 cm). Chez 76 patients (98,7 %), le point de retrecissement a ete localise dans le premier quadrant. Les valeurs de Kappa relativement a la fiabilite inter-evaluateurs etaient respectivement 1,0 et 0,87 pour les techniques 1 et 2. Conclusion : La valeur normale de la PVJ par echographie est de 6,35 cm, une valeur legerement inferieure a la valeur normale publiee. La fiabilite inter-evaluateurs concernant la mesure de la PVJ par echographie est excellente. La partie superieure de la VJI est situee a moins de 25 % de la distance entre la clavicule et l'angle de la machoire chez la majorite des adultes en sante. Nos resultats suggerent que la PVJ par echographie offre la possibilite de reintegrer une mesure fiable de la PVJ dans l'evaluation clinique dans les services d'urgence. Cependant, des recherches plus poussees dans ce domaine sont necessaires., INTRODUCTION The evaluation of jugular venous pressure (JVP) is considered to be a standard component of the physical examination in patients suspected of having acute congestive heart failure. (1) Other [...]

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