Can peripheral venous pressure be interchangeable with central venous pressure in patients undergoing cardiac surgery?
Can peripheral venous pressure be interchangeable with central venous pressure in patients undergoing cardiac surgery?
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DOI：
10.1007/s00134-003-2052-0
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发表时间：
2004-04-01
影响因子：
38.9
通讯作者：
Martineau, R
中科院分区：
文献类型：
--
作者：
Desjardins, R;Denault, AY;Martineau, R
Objective.右心房水平的压力测量通常用于临床麻醉和重症监护室（ICU）。人们越来越关注使用外周静脉部位来估计中心静脉压（CVP）。本研究比较了在不同血流动力学条件下同时测量CVP和外周静脉压（PVP）的偏倚、精密度和协方差。设计和设置。一所三级保健大学附属医院的手术室和ICU。患者对19例需要体外循环的择期心脏手术患者进行了研究。干预。将PVP导管放置在肘前静脉中，并使用T型连接器连接到肺动脉导管的换能器。在心脏手术期间和ICU中的不同时间采集数据。测量和结果。19例患者在各种血流动力学条件下共获得188个测量值，包括机械通气前后，麻醉诱导后，输液，应用呼气末正压和硝酸甘油给药。PVP和CVP值相关且可互换，PVP与CVP相比的偏倚在-0.72和0 mmHg之间。结论. PVP监测可以在手术室和ICU中遇到的各种条件下准确估计CVP。
Objective. Pressure measurements at the level of the right atrium are commonly used in clinical anesthesia and the intensive care unit (ICU). There is growing interest in the use of peripheral venous sites for estimating central venous pressure (CVP). This study compared bias, precision, and covariance in simultaneous measurements of CVP and of peripheral venous pressure (PVP) in patients with various hemodynamic conditions. Design and setting. Operating room and ICU of a tertiary care university-affiliated hospital. Patients. Nineteen elective cardiac surgery patients requiring cardiopulmonary bypass were studied. Interventions. A PVP catheter was placed in the antecubital vein and connected to the transducer of the pulmonary artery catheter with a T connector. Data were acquired at different times during cardiac surgery and in the ICU. Measurements and results. A total of 188 measurements in 19 patients were obtained under various hemodynamic conditions which included before and after the introduction of mechanical ventilation, following the induction of anesthesia, fluid infusion, application of positive end expiratory pressure and administration of nitroglycerin. PVP and CVP values were correlated and were interchangeable, with a bias of the PVP between -0.72 and 0 mmHg compared to the CVP. Conclusions. PVP monitoring can accurately estimate CVP under various conditions encountered in the operating room and in the ICU.