The internal jugular vein is the largest vein in the neck that serves as the main source of blood flow down from the head. Obstruction of blood flow through the internal jugular vein can cause backflow of blood into the brain, increasing intracranial pressure, which can cause serious brain damage if left untreated The right internal jugular vein is about 63 millimeters (mm) long while the left internal jugular vein averages about 53 mm long. The external jugular veins are much smaller in diameter and found much more superficial as compared to the internal jugular veins
Multiple attempts to percutaneously cross the left innominate vein were unsuccessful and the patient was referred for surgical intervention. At 15 years old, the patient was taken to the operating room for transposition of the left internal jugular vein (LIJ) to the right internal jugular vein (RIJ) Similar advancement was noted when inserting the pulmonary artery catheter under fluroscopic guidance. This indicated an obstruction in the confluence of the left internal jugular vein and the brachiocephalic vein. A postoperative chest contrast CT showed thrombosis in the confluence of the left internal jugular vein and the brachiocephalic vein
There are two sets of jugular veins: external and internal. The left and right external jugular veins drain into the subclavian veins. The internal jugular veins join with the subclavian veins more medially to form the brachiocephalic veins. Finally, the left and right brachiocephalic veins join to form the superior vena cava, which delivers deoxygenated blood to the right atrium of the heart The internal jugular veins are paired veins that are placed laterally to the carotid artery on either side of the neck. While the left internal jugular vein is closer to the carotid artery to the extent that it overlaps, there is some distance between the right internal jugular vein and the common carotid artery We have internal and external jugular veins that run along the right and left side of our neck. These veins carry blood from the head to the superior vena cava. The vena cava is the largest vein in.. It is formed by the union of inferior petrosal and sigmoid dural venous sinuses in or just distal to the jugular foramen (forming the jugular bulb). It descends in the carotid sheath with the internal carotid artery. The vagus nerve (CN X) lies between the two Internal jugular vein stenosis (IJVS) is gaining increasing attention from clinical researcher s due to a series of confounding symptoms that impair the quality of life in affected individuals but cannot be explained by other well-established causes. In a study of Zhou et al.,from the Xuanwu Hospital, aimed to elucidate the clinical features, neuroimaging characteristics and pathogenesis of.
Introduction. Retrospective observational study to evaluate the technique of cannulation guided by ultrasound of the left internal jugular vein (LIJV) using a lateral oblique axis (LOAX) approach with variable angulation in the placement of tunneled central venous catheters (CVC) for hemodialysis A useful mnemonic to remember the branches of the internal jugular vein is: Medical Schools Let Fun People In Mnemonic From inferior to superior: M: middle thyroid vein S: superior thyroid vein L: lingual vein F: facial vein P: pharyngeal.. Due to superficial abrasions from the fall to the right side of his neck, the left internal jugular vein was cannulated. On chest radiography (Figure 1) for confirmation, the left internal jugular central venous catheter was seen projecting down the left paraspinal region Cannulation of a central vein (internal jugular vein (IJV), subclavian vein and femoral vein) is a very common procedure. Catheters are inserted for several reasons, including haemodynamic monitoring, delivery of blood products and drugs, total parenteral nutrition, haemodialysis and management of perioperative fluids
Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed. On chest radiography for confirmation, the left internal jugular central venous catheter was seen projecting down the left paraspinal region The right internal jugular vein is the preferred site for HD CVC. If this site is not an option, alternatives include the right external jugular or left internal jugular veins. Subclavian catheters should be avoided because they have a very high risk of stenosis in children Internal jugular vein stenosis (IJVS), characterized by a series of clinical manifestations, such as head and neck symptoms, visual and ear symptoms, as well as sleep disorder, has been receiving attention in recent years. However, its' etiologies are not fully understood. We report a cases series of IJVS induced by styloid oppression
The left internal jugular vein is usually larger than the right (, 4). There are valves present in the jugular veins cranial to their terminations. Venous size can vary due to hydration status, position, intrathoracic pressure, cardiac status, and compression from adjacent structures Percutaneous cannulation of the internal jugular vein uses anatomic landmarks to guide venipuncture and a Seldinger technique to thread a central venous catheter through the internal jugular vein and into the superior vena cava. Three approaches (central, anterior, and posterior) are used; the central approach is described here Introduction. Cannulation of a central vein (internal jugular vein (IJV), subclavian vein and femoral vein) is a very common procedure. Catheters are inserted for several reasons, including haemodynamic monitoring, delivery of blood products and drugs, total parenteral nutrition, haemodialysis and management of perioperative fluids The internal jugular vein is forms in the base of the skull by the merger of the inferior petrosal and sigmoid sinuses. As the vein descends through the neck, tributary veins include the facial, lingual, pharyngeal, superior thyroid, and middle thyroid veins. The right internal jugular vein is often the blood vessel used for medical access to. The internal jugular vein on the right is larger than the left in the majority of patients, with significant diameter discrepancy present in over one-third of patients . As the internal jugular vein descends into the chest, its diameter increases
On ultrasound, her right internal jugular vein was found to be stenosed proximally, and a left internal jugular vein dialysis catheter (20cm, 12 Fr) was placed under ultrasound guidance with no complications Right internal jugular vein is preferred for jugular dialysis catheters due to its straight access into the superior vena cava and the right atrium. These are placed through a tunnel in the subcutaneous plane with a dacron cuff positioned in the center of the tunnel around the catheter The internal jugular vein (really a pair of veins) The left vein is usually smaller than the one on the right, but both possess valves that help transport blood Abstract The right common carotid artery originates from the innominate (brachiocephalic) artery. The external landmark is the right sternoclavicular joint. The left common carotid artery originates directly from the aortic arch in the superior mediastinum. The carotid sheath contains the common and internal carotid arteries, the internal jugular vein, and the vagus nerve The left internal jugular vein revealed thrombosis with an air bubble. The distal end of the fishbone could be seen adjacent to the left internal jugular vein. Treatment plan. The surgeons advised against endoscopic removal because of the high risks associated with the procedure and for better exposure and drainage
aberrant termination: left internal jugular vein, left external jugular vein, azygos vein, brachiocephalic vein or left subclavian vein; multiple terminal channels from single duct with a typical course (~20%) continues on the right to terminate in the right internal jugular vein In this image, you will find superior sagittal sinus, transverse sinus, superficial temporal vein, occipital vein, posterior auricular vein, maxillary vein, retromandibular vein, deep cervical vein, external jugular vein, vertebral vein, subclavian vein, left brachiocephalic vein, jugular venous arch, internal jugular vein
The right (RIJV) or left internal jugular vein (LIJV), respectively, was punctured midway between the mastoid process and the sternal notch, just lateral to the carotid artery pulsation. The vein was entered using a sterile Seldinger technique, the guide wire was advanced and a triple lumen polyurethane CVC was introduced (Certofix ® Trio SB 730, length 30 cm, 7 French) Internal jugular vein thrombosis epidemiology. Upper-limb thrombosis accounts for a maximum of 10% of all deep-vein thromboses [2, 47].IJV thrombosis is even less frequent, but epidemiological studies are lacking (other unusual sites for thrombosis, such as the mesenteric vein, account for 0.002-0.006% of all inpatient admissions) [].. Vascular anomalies of major venous vessels are rarely seen. Moreover, congenital absence of internal jugular vein is extremely uncommon. In our case, a female patient presented with primary unknown left cervical mass. Cervical ultrasonography demonstrated absence of right internal jugular vein. In addition, computed tomography and dynamic magnetic resonance imaging scans confirmed this diagnosis
During resuscitative phase, attempts at left central venous catheter via left internal jugular vein under ultrasound guidance resulted in inadvertent puncture into the left common carotid artery. Surgical neck exploration revealed that the catheter had punctured through the left internal jugular vein into the common carotid artery with formation of arteriovenous fistula Left internal jugular catheters increase the incidence of central vein occlusions and left innominate vein occlusions leading to unilateral arm swelling and at times access ligation [18] [19]. In our case, the hemodialysis catheter had penetrated the wall of the brachiocephalic vein and entered the anterior mediastinum Left Internal Jugular Vein 3 Left Internal Mammary Artery 15 Left Internal from BIOSC 315 at Clemson Universit
catheter was inserted into the external jugular vein. The anteroposterior chest X-ray showed the tip of the catheter, in the left internal jugular vein (Fig. 1). Fig. 1 Malposition of central venous catheter in the left internal jugular vein Discussion Exact placement is an essential prerequisite for long-term use of a central venous catheter Some studies have found that the carotid artery may overlap the internal jugular 54% of the time while 5.5% of the time the IJ vein maybe medial to the carotid artery (Gordon AC, Troianos CA, Denys BG). This stresses the importance of ultrasound localization of the internal jugular vein relative to the carotid artery. Next | To Thoraco-abdominal computed tomography (CT) showed that right jugular and subclavian veins come together, form the right sided SVC, which drains to the right atrium, and left internal jugular vein with left subclavian vein forms the left SVC, which drains to the right atrium via the coronary sinus (Fig
Generally, catheterization via the left internal jugular vein results in more malposition and vascular perforation than a catheter placed from the right internal jugular vein. This is because the right internal jugular vein runs into the right brachiocephalic vein in a fairly straight course whereas the left internal jugular vein forms a greater bend when it becomes in the left brachiocephalic. His left chest was shaved. His neck was rotated right and his left neck and chest were then prepped and draped in standard surgical fashion. The patient was placed in Trendelenburg position and the left neck was anesthetized. An anesthetization needle was used to locate the internal jugular vein Internal jugular vein valve incompetence and intracranial venous anatomy in transient global amnesia. J Neurol Neurosurg Psychiatry. 2005; 76: 509-513. Crossref Medline Google Scholar; 21 Nedelmann M, Eicke B, Dieterich M. Functional and morphological criteria of internal jugular valve insufficiency as assessed by ultrasound. J Neuroimaging
ICD-10-PCS code List for Internal Jugular Vein, Left. ICD-10-PCS code List for Internal Jugular Vein, Left is medical classification list by Centers for Medicare and Medicaid Services (CMS). Subscribe to Codify and get the code details in a flash. Request a Demo 14 Day Free Trial Buy Now Granulicatella adiacens , which occurs as part of the oral microflora, is an uncommon cause of infection. However, it can cause serious bloodstream infections including infective endocarditis. Although oral bacteria, most commonly the Fusobacterium spp, can cause internal jugular vein (IJV) thrombophlebitis, there are no reported cases of IJV thrombosis caused by G. adiacens Question: There Is A Right And Left Brachiocephalic Vein Formed By The The Confluence Of The Left Internal Jugular Vein And The Left Subclavian Vein. The Left Brachiocephalic Vein Joins The Right Brachiocephalic Vein To Form The Superior Vena Cava. True False In Blood Typing, The Test Bottles, Labeled Type A And Type B, Contain Antigens To React With The Antibodies. left internal jugular vein could be entered in all but three procedures (98 percent). Seventeen patients hadmore than one procedure through the same internal jugular vein and the vein was found patent in all. A complete right heart cardiac catheterization was performed using this route
the left internal jugular vein has shown to be a feasible option, allowing the navigation and manipulation of devices without complications. Provided the expertise of the interventional team, and awareness of the risks involved, alternative access sites can be successfully used for paediatric structural interventions Internal Jugular Vein. Describe the anatomy relevant to central venous access (including femoral, internal jugular, external jugular, subclavian and peripheral veins). The internal jugular vein: Originates at the jugular bulb This is a dilatation formed by the confluence of the inferior petrosal sinus and the sigmoid sinus PurposeTo evaluate the presence and causes of left brachiocephalic vein (LBCV) steno-occlusive lesions in patients with loss of normal waveform in Doppler ultrasound of the left internal jugular ve..
View blood pathways lab exam 2.pdf from BIO 122 at Hunter College, CUNY. Lymph pathways: LEFT INTERNAL JUGULAR VEIN From: thoracic duct at junction of left subclavian vein To: left brachiocephali Internal and external jugular veins run along the right and left sides of your neck. They bring blood from your head to the superior vena cava, which is the largest vein in the upper body This vein receives in its course the inferior petrosal sinus, the common facial, lingual, pharyngeal, superior and middle thyroid veins, and sometimes the occipital. The thoracic duct on the left side and the right lymphatic duct on the right side open into the angle of union of the internal jugular and subclavian veins Caption: Figure 1: Dissected body with the clavicles (RC and LC) in situ, right and left internal jugular vein (RIJV and LIJV), right and left external jugular vein (REJV and LEJV), right and left supraclavicular (RSC and LSC) branches of cephalic vein, right and left cephalic vein (RCV and LCV), right and left infraclavicular (RIC and LIC.
The left internal jugular vein is slightly smaller than the right internal jugular vein. Both veins contain valves that are located a few centimeters before the vessels drain into the subclavian vein 1). Like many veins in the body, the internal jugular can have many anatomical variations Internal jugular vein. Generally, the left vein is somewhat smaller and thinner than the right, but both contain valves that assist with blood transport. The vein appears dilated (wider) at two points, and these distinct parts are called the superior bulb and the inferior bulb The jugular veins are located on both sides of the neck and are responsible for moving deoxygenated blood from the head down to the heart. You have two pairs of jugular veins, referred to as the internal and external jugular veins. The external jugular vein is closest to the skin and is the vein you can see bulging Internal jugular vein thrombi should probably be looked at as deep vein thrombi and therefore should probably be treated not only by line removal but also with anticoagulation. There is not enough data to support a clear recommendation as to the length of time for the treatment
Internal jugular vein gets compressed by anterior subluxation of C1 and C0-C1 instability. As mentioned earlier in this article and discussed further in our article on Eagle Syndrome, compression of the internal jugular vein can come from many sources beyond the more researched styloid process.Dr Corpus ID: 46614878. Left internal jugular vein thrombosis due to a lung tumor. @article{Chen2003LeftIJ, title={Left internal jugular vein thrombosis due to a lung tumor.}, author={Kuan-Hsing Chen and Ying-Jen Chen and C. Liaw and Hern-Jia Chang and K. Yeow}, journal={Chang Gung medical journal}, year={2003}, volume={26 6}, pages={ 458-62 } Of note, the right thyroid lobe was compressed by an enlarged right interval jugular vein (IJV) and more posterior in position compared with the left lobe in the transverse view (Figure 1A vs. 1B) The left brachiocephalic vein is longer than the right as it must cross the median plane to reach the right brachiocephalic vein to form cranial vena cava on the right. The caudal thyroid vein and the internal jugular veins enter the brachiocephalic as well as the left costocervical vein in some dogs
Internal jugular (IJ) vein thrombosis refers to an intraluminal thrombus occurring anywhere from the intracranial IJ vein to the junction of the IJ and the subclavian vein to form the brachiocephalic vein. It is an underdiagnosed condition that may occur as a complication of head and neck infections, surgery, central venous access, local mali.. You may use ultrasound guidance (either short- or long-axis) to verify the guidewire entering the vein. Do not force the wire; it should slide smoothly. Advance the wire 10 to 15 cm for a right-sided internal jugular insertion, 15 to 20 cm for a left-sided insertion, or until ectopic heartbeats occur (withdraw from this point until ectopy stops) ICD-10-PCS Body Part - N Medical and Surgical, Upper Veins, Occlusion, Internal Jugular Vein, Left. The Internal Jugular Vein, Left body part is identified by the character N in the 4 th position of the ICD-10-PCS procedure code. It is contained within the Occlusion root operation of the Upper Veins body system under the Medical and Surgical section. The 4 the position refers to the body part. Internal jugular veins (anterior view) Near the junction of the left subclavian vein and the left internal jugular vein, is where the thoracic duct drains.. Within the lympatic system, is lymph, which consists mainly of solutes and water, in addition to chylimocrins which are the bodies transporters of lipids from the intestines.. In a similar fashion, the right thoracic duct drains into the. The thoracic duct on the left side and the right lymphatic duct on the right side open into the angle of union of the internal jugular and subclavian veins. The Inferior Petrosal Sinus (sinus petrosus inferior) leaves the skull through the anterior part of the jugular foramen, and joins the superior bulb of the internal jugular vein
Where does the internal jugular vein start inside the skull. Inside the skull as a dilation of the sigmoid sinus (dural sinus joined by another venous dural Internal jugular vein eventually joins the __ subclavian vein to form the right and left brachiocephalic veins. Internal jugular vein first runs. posterior to the internal carotid arteries Computed tomography (CT) of the neck revealed a vascular filling defect in the left internal jugular vein to left subclavian vein region, with the venous lumina completely occluded with dense soft tissue. On the basis of the findings, we made the diagnosis of thrombosis of the left internal jugular and left subclavian veins Left internal jugular vein - The Anatomy of the Veins Visual Guide, page 9 (of 52) This is page 9 of a photographic atlas I created as a laboratory study resource for my BIOL 121 Anatomy and Physiology I students on the anatomy of the veins The internal jugular veins collect blood from the brain as well as the superficial structures of the head and neck before descending through the neck towards the heart. Innerbody Research is the largest home health and wellness guide online, helping over one million visitors each month learn about health products and services
Examples of condylar veins with and without collateral flow. Two axial images from a CTA of the neck demonstrate differential contrast attenuation in the condylar veins. The left condylar veins (solid arrows) are isoattenuated with the right internal jugular vein (arrowhead). The left internal jugular vein is markedly attenuated Color Doppler ultrasound revealed that the left internal jugular vein was blocked up by 50 % with a hypervascular tumor thrombus of 22x4 mm size in the longitudinal plan. The left thyroid lobe was observed to surround the common carotid artery with an angle of 135 degrees and the echogenic fatty plan was disrupted between these two structures Internal Jugular Central Venous Line INDICATIONS. Central venous access for infusion of vasoactive drugs, TPN, high dose KCl, etc. Insertion of a catheter into the femoral vein, not shown in this video, has the highest risk of mechanical complications, but the. (a) Blood from the superficial cerebral veins tends to drain into the right internal jugular vein after passing successively through the superior sagittal sinus, right transverse and sigmoid sinuses. (b) Blood from the deep cerebral veins tends to drain into the left internal jugular vein as it flows successively through the great cerebral vein (of Galen), straight sinus, left transverse and.
Rents and sharp transection in the internal jugular vein without segmental loss can often be repaired primarily using a running, nonabsorbable fine suture as was in our case. In case there are large through-and through wounds or there is segmental loss of vein ligation is preferred which is well tolerated [8] Internal Jugular Vein 1. INTERNAL JUGULAR VEIN V.S.RASHMI PRIYEM ULTRA'S BEST Dental Science College 2. IJV - Course • It begins as the Direct Continuation Of The Sigmoid Sinus at the base of the skull below the jugular foramen • Descends vertically downwards to end behind the sternal end of the clavicle by joining the Subclavian Vein to form the Brachiocephalic Vein Rashmi Priyem Saravana 05LN3ZZ is a valid billable ICD-10 procedure code for Occlusion of Left Internal Jugular Vein, Percutaneous Approach.It is found in the 2021 version of the ICD-10 Procedure Coding System (PCS) and can be used in all HIPAA-covered transactions from Oct 01, 2020 - Sep 30, 2021
Other unusual catheter tip placements reported are in the left internal mammary vein, azygous vein, hemiazygos vein, lateral thoracic vein, inferior thyroid vein, left superior intercostal vein, thymic vein, pleural cavity, and the jugular foramen.[2-4] During subclavian vein catheterization, the most common misplacement of the catheter is cephalad, into the ipsilateral internal jugular vein. Due to an intraoperative injury to the right internal jugular vein, the left internal jugular vein was chosen for access under the same anaesthetic. A 6.6 Fr Hickman catheter was placed in the left internal jugular vein using the 'cut-down' technique with no difficulties Comparison of High-Flow Hemodialysis Catheters Placed From the Left Internal Jugular Vein(R12-022) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government left condylar veins (solid arrows) are isoattenuated with the right internal jugular vein (arrowhead). The left internal jugular vein is markedly attenuated. Note that the right-sided condylar veins (dashed arrows) have similar caliber to the left but are not filled with contrast of the same attenuation
internal jugular vein LIJV left internal jugular vein 6 mo 6-month follow-up examination MRV MR venography MS multiple sclerosis NPV negative predictive value PPV positive predictive value PTA percutaneous transluminal angioplasty RIJV right internal jugular vein TOF 2D time-of-flight venography TRICKS 3D time-resolved imaging of contrast kinetic Lemierre's syndrome is an uncommon septic thrombophlebitis of the internal jugular vein. The authors present the case of a 52-year-old woman with literature review. She developed flu-like symptoms and fever, and then painful swelling of the left side of her neck and left arm Valid for Submission. I82.C12 is a billable diagnosis code used to specify a medical diagnosis of acute embolism and thrombosis of left internal jugular vein. The code I82.C12 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions N2 - Purpose: To retrospectively review the indications and outcomes of transjugular liver biopsy (TJLB) with the left internal jugular vein (IJV) approach. Materials and methods: A retrospective review of all TJLBs performed at one institution was performed. From August 1995 to October 2004, 293 liver biopsies were performed Neck ultrasound revealed a heterogeneous mass distending the left internal jugular vein with associated flow on Doppler examination (Fig. 1a-c). Post-contrast CT confirmed the intra-luminal location of this mass, with only a small rim of contrast between it and the vessel wall (Fig. 2a). Small enhancing vessels were seen within the mass (Fig. 2b)
Quick Image Reference. Figure 1: Still image of internal jugular vein in transverse view. Figure 2: Still image of a peripheral vein. Figure 3: Linear probe with sterile sheath cover. Video clip 1: Shows compression of left internal jugular vessel. Figure 4: Patient preparation and position for right IJ central line placement.. Ghosh S, Dewan H, Bhattacharyya S. A rare malposition of the thoracic venous catheter introduced via the left internal jugular vein. Indian J Crit Care Med 2008;12:201-3. 4. Sandroni C, Pirronti T, Tortora F, Santangelo S, Rinaldi P, Antonelli M. Unusual central venous catheter malposition into the left internal mammary vein: A case report
Jugular Veins. The jugular veins are veins that bring deoxygenated blood from the head back to the heart via the superior vena cava. There are two sets of jugular veins: external and internal. Both connect to the brachocephalic veins, the external jugular joining more laterally than the internal the internal and external jugular veins on eith r side of the neck, and it is said to occur more often on the left in adults.8 Such a left-sided distribution is not supported for the internal jugular vein, at least on the basis of several reports, 2·3•5•6•8• 9 in which the tendency was for right internal jugular vein di lation
The right vein is preferred because. it enters the right atrium directly. In contrast, the left internal jugular has to take a longer, more angular path to the heart (see figure) there is no valve between the right internal jugular vein and right atrium, improving the wave transmission between the vein and atrium Research Hospitalization Volume, DRGs, Quality Outcomes, Top Hospitals & Physicians for 057N3DZ - Dilation of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Approach - ICD 10 Procedure Cod External jugular vein: The more superficial of the two jugular veins situated on each side of the neck. The other is the internal jugular vein. They drain blood from the head, brain, face and neck and convey it toward the heart.. The external jugular vein collects most of the blood from the outside of the skull and the deep parts of the face Context: Cannulation of internal jugular vein (IJV) by using the anatomical landmarks is associated with a significant complication rate of up to 15%. Aim: The aim of our study was to determine the anatomical characteristics of IJV in relation to common carotid artery (CCA) using ultrasonography (USG). Materials and Methods: This prospective observational study was carried out in a tertiary.
I82.C12 - Acute embolism and thrombosis of left internal jugular vein is a topic covered in the ICD-10-CM.. To view the entire topic, please sign in or purchase a subscription.. ICD-10-CM 2021 Coding Guide™ from Unbound Medicine Catheterisation of the right side is preferred as the internal jugular and innominate veins and the superior vena cava are nearly in a straight line, although the left internal jugular vein has been used with equal facility on several occasions. In infants and small children where the head is relatively large and th and following-up internal jugular vein thrombosis are not clearly defined and mostly based on adapted guidelines for lower-limb thrombosis. Case presentation: A 52-year-old Caucasian woman came to the Emergency Department with chest, neck, and left arm pain. Computed tomography imagery showed a left internal jugular vein thrombosis. An. Internal jugular vein: The deeper of the two jugular veins in the neck that drain blood from the head, brain, face and neck and convey it toward the heart. The internal jugular vein collects blood from the brain, the outside of the face and the neck. It runs down the inside of the neck outside the internal and common carotid arteries and unites with the subclavian vein to form the innominate vein left internal jugular vein may be related to the present results, that is, the longer time was needed to pass the tricuspid valve. The present study was designed to place a PAC by monitoring the pressure waveform, and we started the measurement after the CVP waveform was confirmed
