Introduction: Accurate assessment of intravascular volume status after pediatric cardiac surgery is essential, and current practice still relies on central venous pressure (CVP) despite its risks and limitations. We hypothesized that bedside point-of-care ultrasound (POCUS) evaluation of internal jugular vein (IJV) parameters would correlate with CVP in extubated, spontaneously breathing children following cardiac surgery and may offer an alternative to the standard inferior vena cava (IVC)–based measurements in this population. Methods: This prospective cross-sectional study was performed in the pediatric cardiac critical care unit at a tertiary children’s hospital. Children < 18 years old who were extubated, spontaneously breathing, and had an upper-extremity central venous line were enrolled. CVP was obtained immediately prior to sonographic measurements, followed by the acquisition of a series of images used to calculate IJV/Common Carotid Artery (CCA) ratio in addition to both IJV and IVC collapsibility indices. Associations between CVP and IJV/CCA ratio as well as collapsibility indices were assessed using correlation coefficients and 95% confidence intervals. Results: Fifteen patients were enrolled, with a median age of 4.5 months (IQR 2–6 months). The median CVP was 8 cm H2O (IQR 3–10 cm H2O). A strong inverse correlation was found between CVP and IJV collapsibility index (R = -0.79, p < 0.01). A moderate inverse correlation was observed between CVP and IVC collapsibility index (R = -0.56, p = 0.05). The IJV/CCA ratio demonstrated a moderate positive correlation with CVP (R = 0.56, p = 0.01). Conclusions: In extubated postoperative pediatric cardiac surgery patients, IJV measurements accurately reflect CVP and may have clinical utility as a non-invasive tool in assessing volume status at the bedside. Larger-scale studies are needed to establish a more definitive relationship between these variables and better determine clinical applicability.
Guzmán et al. (Sun,) studied this question.