Comparison of accuracy of central venous pressure (CVP) estimation in internal jugular vein (IJV) by ultrasound and conventional method (using saline column): An observational study

Praveen Kumar Devarajan, Elamurugan Thirthar Palanivelu, Ramkumar Govindarajalou, Kumar Saya, Rajeshwari JOSEPH ALEXIS, Rajendra Kagne, Aishwarya Sampath
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Abstract

Aim & background: Central venous pressure (CVP) is needed in acute resuscitation and in intensive care unit patients to monitor hemodynamics and to guide fluid resuscitation. The primary objective of our study is to compare the ultrasound (USG) guided measurement of CVP with conventional measurement of CVP using saline column. Methods: The study is Prospective observational study. The study was conducted at a tertiary care teaching hospital from February 2020 to December 2021. 245 patients were included in this study using convenient sampling technique. The primary measure in this study is to assess whether the accuracy of USG measurements (non invasive) of CVP is as good as conventional measurements (invasive) of CVP using saline column method. Results: The CVP measurements measured invasively and non invasively were categorized as below normal, normal, and above normal. Using CVP (saline) as the gold standard, for CVP (USG) and CVP (saline) a 3 x 3 contingency table had been made. To compare the diagnostic accuracy between CVP(Saline) and CVP(USG) where the measurements were categorised, Kappa statistics has been used to measure the agreement between the two {CVP (saline) and CVP (USG)}. The Kappa value was found to be around 96.33% and after weightage was 97.96% which was almost perfect agreement. Conclusion: Based on our study, we conclude that the USG guided measurement of CVP is as good as conventional measurement of CVP using saline column.
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比较超声和传统方法(使用生理盐水柱)估测颈内静脉中心静脉压(CVP)的准确性:观察研究
目的和背景:急性复苏和重症监护室患者需要中心静脉压(CVP)来监测血液动力学并指导液体复苏。我们研究的主要目的是比较超声(USG)引导下的 CVP 测量和使用生理盐水柱的传统 CVP 测量。方法:本研究为前瞻性观察研究。研究于 2020 年 2 月至 2021 年 12 月在一家三级医疗教学医院进行。本研究采用方便抽样技术,共纳入 245 名患者。本研究的主要目的是评估 USG 测量(无创)CVP 的准确性是否与使用生理盐水柱法测量(有创)CVP 的准确性相同。结果:有创和无创测量的 CVP 分为低于正常、正常和高于正常。以 CVP(生理盐水)为金标准,对 CVP(USG)和 CVP(生理盐水)进行了 3 x 3 或然率分析。为了比较 CVP(生理盐水)和 CVP(USG)之间的诊断准确性,在测量结果被分类的情况下,使用了 Kappa 统计法来衡量两者之间 {CVP (生理盐水)和 CVP (USG)} 的一致性。结果发现 Kappa 值约为 96.33%,加权后为 97.96%,几乎完全一致。结论:根据我们的研究,我们得出结论,USG 引导下的 CVP 测量与使用生理盐水柱的传统 CVP 测量一样好。
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