Compression pressure of the external jugular vein for the assessment of intravascular volume status in decompensated cirrhosis: A pilot study

Intravascular volume overload after albumin infusion is a major concern in patients with decompensated cirrhosis and was observed in its most severe form in 20% of patients using POCUS-IVC (point-of-care ultrasound of the inferior vena cava). In this pilot study, we detected substantial volume shifts during passive leg raise and after albumin infusion using both POCUS-IVC and a novel external jugular vein compression technique (CPMX2) in parallel. CPMX2 appeared more sensitive to dynamic changes during passive leg raise and identified a larger proportion of patients with intravascular volume overload following intravenous albumin. These findings suggest that CPMX2 could serve as a promising non-invasive tool for early assessment and individualized monitoring of volume status in decompensated cirrhosis.