Diagnostic accuracy of a simple ultrasound measurement to estimate central venous pressure in spontaneously breathing, critically ill patients.

Background: Early goal-directed therapy for severe sepsis or septic shock improves outcomes but requires placement of a central venous catheter to measure central venous pressure (CVP), which may delay timely resuscitation and cause catheter-related complications. In addition, nonintensivists may not start early aggressive fluid resuscitation because of difficulty estimating CVP and concerns for inadvertent volume overload.

Objective: To determine if the CVP target of 8 to 12 mm Hg can be accurately assessed using noninvasive ultrasound to measure the internal jugular vein aspect ratio (height/width).