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The Accuracy of IJV/CCA CSA Ratio Measurement for Assessing Volume Status and CVP: A Systematic Review

  • Writer: AIOR Admin
    AIOR Admin
  • Nov 26
  • 2 min read

Mansoureh Fatahi, Marziyeh Rashidi

Shahid Beheshti University of Medical Sciences (Iran), Klinikum Dortmund (Germany)


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Introduction: Intravenous fluid administration is commonly used in healthcare settings. Yet, there is no gold standard for evaluating the efficacy of fluid therapy. Ultrasound can assess the volume statically and dynamically. One proposed static method involves comparing the cross-sectional diameter of the internal jugular vein to that of the common carotid artery, allowing for normalization of the internal jugular size relative to the common carotid artery size. Here, we planned to assess the value of this method for evaluating volume status. Method: This systematic review followed PRISMA guidelines to examine the value of the internal jugular vein to common carotid artery cross-sectional ratio for assessing volume status. An extensive search was conducted in July 2025 across PubMed, Web of Science, Scopus, and Embase, with additional manual searches of Google Scholar and gray literature. The PICO framework was used to define inclusion criteria for original research studies that directly assessed the diagnostic accuracy of this ratio against a reference standard. Two independent reviewers extracted data and assessed study quality using the QUADAS-2 tool. Due to the limited number of studies, a planned meta-analysis was replaced by a narrative report of the results. Results: Five studies with a total of 183 patients were assessed. The mean age of participants ranged from 7 to 58.86 years. Most studies used CVP as the reference test. Two works reported a correlation between the IJV/CCA CSA ratio and CVP, with cutoff values of 2, while one study suggested a cutoff of 1.66. Another investigation proposed a cutoff of 1.8 when the patient was in a 45-degree position, and one study recommended varying cutoffs based on different physiological conditions influenced by respiratory status. Conclusion: The IJV/CCA CSA ratio demonstrates potential utility in assessing central venous pressure, with an estimated cutoff value near 2. However, the applicability of these findings is constrained by limited study sizes and considerable variability in both populations and research protocols.




 
 
 

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