Role of the internal jugular venous valve during an increase in intrathoracic pressure

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We investigated the ability of the internal jugular venous valve (IJVV) to buffer the transmission of pressure to the cerebral venous system during intrathoracic hypertension, by analyzing its transvalvular pressure gradients. The subjects were seven patients who underwent general anesthesia for oral surgery. After induction of anesthesia, one catheter was percutaneously inserted into the superior bulb of the internal jugular vein and another into the superior vena cava via the subclavian vein. These catheters were used to simultaneously monitor the internal jugular venous pressure (IJVP) and the superior vena caval pressure (SVCP). Pressure waves were recorded during intrathoracic hypertension caused by coughing at emergence. We examined the relationship of SVCP with the difference (？P) between variations in SVCP and IJVP. The SVCP had a positive linear correlation with ？P (？P mmHg=0.69 ・ SVCP-10.25, n = 101, r=0.837). Even when the SVCP increased significantly (>50 mmHg), the elevation in IJVP was suppressed, suggesting that the IJVV is usually competent during sudden increases in intrathoracic pressure.
大阪歯科学会の論文