Estimation of central venous pressure by ultrasound of the internal jugular vein

This article describes a simple, new technique using ultrasound (US) to estimate central venous pressure (CVP). The sonographic patterns of the internal jugular vein (IJV) with a low, normal, and elevated CVP are also described. Although bedside visual inspection of the height of the jugular veins as an estimate of CVP has been an integral part of the physical examination, its major limitation has been that the jugular veins are not always observable. In obese patients, a layer of fat often obscures the jugular pulsations. US has proven to be a powerful tool to noninvasively visualize neck veins in the emergency department. Bedside US of the IJV, performed by emergency physicians, provides immediate, important information that cannot be obtained without invasive catheters.