Seeing beneath the surface: Harnessing point-of-care ultrasound for internal jugular vein evaluation

Abstract

Point-of-care ultrasound (POCUS) of the internal jugular vein (IJV) offers a non-invasive means of estimating right atrial pressure (RAP), especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery. While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein, this method lacks sensitivity. The utilization of POCUS significantly enhances the visualization of the vein, leading to a more accurate identification. It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation. This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein, drawing upon existing data.

Keywords: Point-of-care ultrasound; Bedside ultrasound; Internal jugular vein; Right atrial pressure; Central venous pressure

Core Tip: Point of care ultrasound of the internal jugular vein serves as a non-invasive tool to evaluate right atrial pressure. This is particularly useful when neck vein inspection is challenging, or inferior vena cava sonography lacks reliability. When combined with the physical examination and other sonographic parameters, it becomes a valuable component of bedside hemodynamic evaluation.