The Importance of Posture and Skin-Site Selection on Remote Measurements of Neck Pulsations: An Ultrasonographic Study

Moço, Andreia; Hamelmann, Paul; Stuijk, Sander; Haan, G. de

doi:10.1109/embc.2018.8513651

Cited by 7 publications

(15 citation statements)

References 13 publications

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“…For the first time, average JVP waveforms were computed for each subject. A wider variety of JVP pulse morphologies were observed than in previous works measuring the JVP remotely at the external or internal jugular vein [14][15][16] . The different pulse shape classes could be a specific trait of the sensing location of the anterior neck, or simply different morphologies were not revealed in previous studies because averaging of the obtained JVP waveforms was not investigated.…”

Section: Discussionmentioning

confidence: 63%

“…experimental protocol. Signals were recorded from 20 subjects (15 males and 5 females), with average age (2020) 10:3466 | https://doi.org/10.1038/s41598-020-60317-7 www.nature.com/scientificreports www.nature.com/scientificreports/ subjects were asked to be in a lying down position, since it was hypothesized (and confirmed) that JVP pulsations could not be properly sensed if participants were seated 15 . This is due to the fact that when the body is lying down, the venous return does not have to counteract the effect of gravity to pump blood back to the heart from the lower extremities, and blood is pumped more easily to the head.…”

Section: Methodsmentioning

confidence: 99%

“…A different approach, based on a video imaging photoplethysmographic system, demonstrated that, with the subject still in supine position it was feasible to extract the JVP waveform from the neck 14 . Another recent study 15 , showed that camera-based skin micro-motion vibrocardiography (cVCGI) with subjects in recumbent-to-supine position could sense skin-displacement caused by jugular vein pulsations. Similarly, Lam Po Tang et al 16 non-contact alternative was based on using a comodity camera and a subpixel image registration algorithm to identify the same jugular skin displacements.…”

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confidence: 99%

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Extracting the Jugular Venous Pulse from Anterior Neck Contact Photoplethysmography

García-López

Rodriguez‐Villegas

2020

Sci Rep

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The jugular venous pulse (JVP) is the reference physiological signal used to detect right atrial and central venous pressure (CVP) abnormalities in cardio-vascular diseases (CVDs) diagnosis. Invasive central venous line catheterization has always been the gold standard method to extract it reliably. However, due to all the risks it entails, novel non-invasive approaches, exploiting distance cameras and lasers, have recently arisen to measure the JVP at the external and internal jugular veins. These remote options however, constraint patients to very specific body positions in front of the imaging system, making it inadequate for long term monitoring. In this study, we demonstrate, for the first time, that reflectance photoplethysmography (PPG) can be an alternative for extracting the JVP from the anterior jugular veins, in a contact manner. Neck JVP-PPG signals were recorded from 20 healthy participants, together with reference ECG and arterial finger PPG signals for validation. B-mode ultrasound imaging of the internal jugular vein also proved the validity of the proposed method. The results show that is possible to identify the characteristic a, c, v pressure waves in the novel signals, and confirm their cardiac-cycle timings in consistency with established cardiac physiology. Wavelet coherence values (close to 1 and phase shifts of ±180°) corroborated that neck contact JVP-PPG pulses were negatively correlated with arterial finger PPG. Average JVP waveforms for each subject showed typical JVP pulses contours except for the singularity of an unknown "u" wave occurring after the c wave, in half of the cohort. This work is of great significance for the future of CVDs diagnosis, as it has the potential to reduce the risks associated with conventional catheterization and enable continuous non-invasive point-of-care monitoring of CVP, without restricting patients to limited postures.

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Section: Discussionmentioning

confidence: 63%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Extracting the Jugular Venous Pulse from Anterior Neck Contact Photoplethysmography

García-López

Rodriguez‐Villegas

2020

Sci Rep

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“…The characteristics of these SRVI signals and their relationship to ECG align with published properties of jugular and arterial signals, with the exception of the absence of a “v” wave, which typically presents as a relatively small amplitude wave in the after the offset of the ventricular repolarization and prior to atrial depolarization (i.e., in the TP segment) ( García-López & Rodriguez-Villegas, 2020 ). The anatomical position of the subjects (seated) may contribute to this deviation from the expected JV pulse waveform, as observed by other investigators collecting this waveform in a seated position ( Moço et al, 2018a ; Proto et al, 2021 ).…”

Section: Resultsmentioning

confidence: 55%

Feasibility of Specular Reflection Imaging for Extraction of Neck Vessel Pressure Waveforms

Saiko

Burton

Douplik

2022

Front. Bioeng. Biotechnol.

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Cardiovascular disease (CVD) is a leading cause of death worldwide and was responsible for 31% of all deaths in 2015. Changes in fluid pressures within the vessels of the circulatory system reflect the mechanical function of the heart. The jugular venous (JV) pulse waveform is an important clinical sign for assessing cardiac function. However, technology able to aid evaluation and interpretation are currently lacking. The goal of the current study was to develop a remote monitoring tool that aid clinicians in robust measurements of JV pulse waveforms. To address this need, we have developed a novel imaging modality, Specular Reflection Vascular Imaging (SRVI). The technology uses specular reflection for visualization of skin displacements caused by pressure pulsations in blood vessels. SRVI has been tested on 10 healthy volunteers. 10-seconds videos of the neck illuminated with a diffuse light source were captured at 250 fps. SRVI was able to identify and discriminate skin displacements caused by carotid artery and jugular vein pulsations to extract both carotid artery and jugular vein waveforms, making them easier to be visualized and interpreted. The method provided a 6-fold improvement in signal strength over a comparator remote PPG dataset. The current pilot study is a proof-of-concept demonstration of the potential of Specular Reflection Vascular Imaging for extraction of JV pulse waveforms.

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“…There has been recent interest in non-invasive and noncontact optical jugular venous monitoring. Skin surface displacement assessment from video [17], [18], [19] can enhance jugular venous pulse identification, but does not contain information related to jugular distension. Other methods have been derived from non-contact photoplethysmographic imaging systems that traditionally monitor arterial hemodynamics [20].…”

Section: Introductionmentioning

confidence: 99%

Optical Hemodynamic Imaging of Jugular Venous Dynamics During Altered Central Venous Pressure

Amelard¹,

Robertson²,

Patterson³

et al. 2020

Preprint

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An optical imaging system is proposed for quantitatively assessing jugular venous response to altered central venous pressure. Methods: The proposed system assesses sub-surface optical absorption changes from jugular venous waveforms with a spatial calibration procedure to normalize incident tissue illumination. Widefield frames of the right lateral neck were captured and calibrated using a novel flexible surface calibration method. Jugular venous optical attenuation (JVA) signals were computed using an optical model for quantifying hemodynamic changes, and a jugular venous pulsatility map was computed using a time-synchronized arterial waveform. JVA was assessed in three cardiovascular protocols that altered central venous pressure by inducing acute central hypovolemia (lower body negative pressure), venous congestion (head-down tilt), and impaired cardiac filling (Valsalva maneuver). Results: JVA waveforms exhibited biphasic properties and sub-wave timing consistent with jugular venous pulse dynamics with timesynchronized electrocardiogram waves. JVA correlated strongly (median, interquartile range) with invasive central venous pressure during graded central hypovolemia (r=0.85, [0.72, 0.95]), graded venous congestion (r=0.94, [0.84, 0.99]), and impaired cardiac filling (r=0.94, [0.85, 0.99]). Reduced JVA during graded acute hypovolemia was strongly correlated with reductions in stroke volume (SV) (r=0.85, [0.76, 0.92]) from baseline (SV: 79 ± 15 mL, JVA: 0.56 ± 0.10 a.u.) to −40 mmHg suction (SV: 59 ± 18 mL, JVA: 0.47 ± 0.05 a.u.; p<0.01). Conclusion:The proposed non-contact optical imaging system demonstrated jugular venous dynamics consistent with invasive central venous monitoring during three protocols that altered central venous pressure. Significance: This system provides non-invasive monitoring of pressure-induced jugular venous dynamics in clinically relevant conditions where catheterization is traditionally required, enabling monitoring in non-surgical environments.

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The Importance of Posture and Skin-Site Selection on Remote Measurements of Neck Pulsations: An Ultrasonographic Study

Cited by 7 publications

References 13 publications

Extracting the Jugular Venous Pulse from Anterior Neck Contact Photoplethysmography

Extracting the Jugular Venous Pulse from Anterior Neck Contact Photoplethysmography

Feasibility of Specular Reflection Imaging for Extraction of Neck Vessel Pressure Waveforms

Optical Hemodynamic Imaging of Jugular Venous Dynamics During Altered Central Venous Pressure

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