Comparative study on central venous pressure evaluation in jugular or subclavian and femoral accesses
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KeywordsCatheter Emergency Medicine Linear Correlation Central Venous Catheter Pressure Transducer
To compare central venous pressure (CVP) measurements obtained in two different locations (jugular or subclavian veins and femoral veins).
A 16-bed medical–surgical ICU.
Materials and methods
The patients enrolled had central venous catheters (CVC) in two different locations, one placed in the internal jugular or subclavian veins and a second in a femoral vein. Simultaneous measurements of CVP were undertaken by two different operators, with a pressure transducer zero-referenced at the mid-chest. Standard CVC with similar features (20 cm length) were used. Patients with intra-abdominal pressure (IAP) >15 mmHg were excluded. The IAP was previously evaluated in all patients using the method described by Sugrue and Hillman. A linear correlation analysis was performed, considering significant P > 0.05 and a correlation coefficient >0.85.
Twenty four patients were studied and three patients were excluded. The mean age was 61.2 ± 9.3 years, the ICU stay was 9.8 ± 4.1 days, the APACHE II score was 24.8 ± 5.7, and SAPS II was 52.7 ± 10.4. The mean CVP measured with jugular or subclavian access was 12.1 ± 4.1 mmHg and 12.9 ± 4.2 mmHg at the femoral access. A good correlation between measurements was found with a correlation coefficient and P > 0.001.
CVP can be accurately measured in femoral accesses, using standard CVC in patients with normal intra-abdominal pressure.