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Although recognized as a questionable indicator of the intravascular volume, central venous pressure (CVP) is integrated in many therapeutic algorithms for hemodynamic resuscitation of critically ill patients [1]. In an attempt to simplify CVP estimation, several clinical and ultrasonographic approaches have been suggested [2-5]. Nonetheless, the external jugular vein (EJV) circumference and area have not been evaluated. Considering the role of EJV visual assessment in the clinical estimation of CVP, we hypothesized that EJV ultrasound evaluation could be used to reliably estimate CVP.

Mixed venous oxygen saturation (SVO2) represents a well-recognized parameter of oxygen delivery (DO2)-consumption (VO2) mismatch and its use has been advocated in critically ill patients in order to guide hemodynamic resuscitation [1] and oxygen delivery optimization. Nevertheless, the pulmonary artery catheter (PAC) is not readily available and its use is not devoid of risks. Furthermore, its use has been decreasing in recent years in surgical and cardiac surgical patients as the benefit of guiding therapy with this device is unclear [2-4]. Central venous oxygen saturation (ScVO2) has been suggested as an alternative to SVO2 monitoring due to its feasibility in several settings. Unfortunately concerns arise from its capability to correlate with SVO2, the relationship being influenced by several factors, such as hemodynamic impairment and pathological process. Hemodynamic instability and shock often complicate cardiac surgery, and the SVO2-ScVO2 relationship has not been specifically investigated in this setting. The aim of this study is to compare SVO2 and ScVO2 values in patients with cardiogenic shock after cardiac surgery.