Estimation of central venous pressure by examination of jugular veins

Attempts were made in 39 seriously ill patients to estimate the central venous pressure (measured through an intrathoracic venous catheter) by clinical examination of the jugular veins. Internal jugular veins were usually not visible. Inspection of the external jugular veins resulted in 103 measurements. These correlated poorly with the actual CVP, since only 47 per cent of the pooled observations were within 2 cm. of the recorded value. To obtain a 90 per cent coincidence, an error of up to 4 cm. had to be allowed. Moreover, large discrepancies were noted in individual cases. The central venous pressure cannot be reliably estimated by inspection of the jugular veins.