Correlation of peripheral venous pressure and central venous pressure in surgical patients

Amar, David; Melendez, Jose; Zhang, Hao; Dobres, Catherine; Leung, Denis H. Y.; Padilla, Roger E.

doi:10.1053/jcan.2001.20271

Cited by 86 publications

(77 citation statements)

References 10 publications

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“…The results of our study showed well-maintained mean difference and correlation between PVP and CVP during low and medium ranges of CVP. Moreover, in Amar et al, 15 the response to the fluid challenge after maintaining low CVP was identical for PVP and CVP. Similarly, in our study, the increase in PVP and CVP were almost identical during the fluid replacement after the removal of transected liver (6.0 Ϯ 2.12 to 8.4 Ϯ 2.71 mmHg and 4.8 Ϯ 1.91 to 7.0 Ϯ 2.53 mmHg, respectively).…”

Section: Discussionmentioning

confidence: 87%

“…16 Recently, however, numerous studies have reported a strong correlation between CVP and PVP in various surgeries. 15,16,19,23,24 In a study performed by Hoftman et al, 19 a very high correlation between 2 pressures was observed in 9 patients undergoing orthotopic liver transplantation, but they noticed weaker CVP-PVP correlation at low filling pressures. On the contrary, Dessiris 23 reported that there was a good correlation between CVP and PVP in hypovolemic dogs even when CVP was as low as 0 mmHg and 2 pressures increased in parallel in response to fluid resuscitation.…”

Section: Discussionmentioning

confidence: 93%

“…21 Previous studies have shown that neither peripheral intravenous catheter size nor site of catheter placement in the arm interfere with the agreement of PVP and CVP. 15,22 Although both peripheral migration of the catheter and decreasing its diameter increased the PVP-CVP gradient, these failed to reach statistical significance. 22 However, in our study, we placed only 18-gauge catheters near the antecubital area to completely eliminate any potential effects of catheter size and site of catheter placement.…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, Dessiris 23 reported that there was a good correlation between CVP and PVP in hypovolemic dogs even when CVP was as low as 0 mmHg and 2 pressures increased in parallel in response to fluid resuscitation. Furthermore, Amar et al 15 reported that the degree of agreement was actually stronger in the low (0-5 mmHg) and medium (6-12 mmHg) ranges of CVP than in the high range (Ͼ12 mmHg) in surgical patients without significant cardiac dysfunction. Keeping CVP low has been advocated during hepatectomy because elevated CVP is considered as one of the major determinants of bleeding from liver parenchyma and excessive fluid administration can decrease hepatic blood flow and oxygenation and induce graft edema secondary to extravasation of fluid.…”

Section: Discussionmentioning

confidence: 99%

“…14 Peripheral venous pressure (PVP) monitoring via peripheral intravenous catheter in the arm has been described to be very safe and convenient with the easy accessibility and suggested as a comparable alternative to CVP measurement. [15][16][17] PVP reflects an "upstream" venous variable that is coupled to CVP by a continuous column of blood. 17 Some studies have reported a good correlation between CVP and PVP and the potential of PVP functioning as a predictor of CVP in various surgical patients, [16][17][18][19][20] whereas others have shown disagreement by indicating that PVP measurement does not give an accurate estimate of CVP and warned against this replacement.…”

mentioning

confidence: 99%

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Can peripheral venous pressure be an alternative to central venous pressure during right hepatectomy in living donors?

Choi

Gwak

et al. 2007

Liver Transpl

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The safety of living donors is a matter of cardinal importance in addition to obtaining optimal liver grafts to be transplanted. Central venous pressure (CVP) is known to have significant correlation with the amount of bleeding during parenchymal transection and many centers have adopted CVP monitoring for right hepatectomy. However, central line cannulation can induce some serious complications. Peripheral venous pressure (PVP) has been suggested as a comparable alternative to CVP. The aim of this study was to determine whether a clinically acceptable agreement or a reliable correlation between CVP and PVP exist and if CVP can be replaced by PVP in living liver donors. A central venous catheter was placed through the right internal jugular vein and a peripheral venous catheter was inserted at antecubital fossa in the right arm. CVP and PVP were recorded in 15-minunte intervals in 50 adult living donors. The paired data were divided into 3 stages: preparenchymal transection, parenchymal transection, and postparenchymal transection. A total of 1,430 simultaneous measurements of CVP and PVP were recorded. Overall, the PVP, CVP, and bias were 7.0 Ϯ 2.46, 5.9 Ϯ 2.32, and 1.16 Ϯ 1.12 mmHg, respectively. A total of 88.9% of all measurements were clinically within acceptable limits of bias (Ϯ2 mmHg). Regression analysis showed a high correlation coefficient between PVP and CVP (r ϭ 0.893; P Ͻ 0.001) and the limits of agreement were Ϫ1.03 to 3.34 overall. In conclusion, frequencies of differences, bias, correlation coefficient, and limits of agreement between PVP and CVP remained relatively constant throughout the operation. Therefore, PVP measurement in the arm can be an alternative to predict CVP and further, obviate central venous catheter-related complications in living liver donors.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Can peripheral venous pressure be an alternative to central venous pressure during right hepatectomy in living donors?

Choi

Gwak

et al. 2007

Liver Transpl

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Reversal of Adverse Hemodynamic Effects of Pneumoperitoneum by Pressure Equilibration

Bickel¹

2004

Arch Surg

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The creation of positive-pressure pneumoperitoneum during laparoscopic operations can lead to adverse hemodynamic changes, mainly decreased cardiac output. We hypothesized that pneumatic compression sleeves worn on the legs during pneumoperitoneum could abolish the pressure gradient between the abdominal cavity and the legs and so eliminate these adverse hemodynamic changes. Design: Prospective, randomized, controlled clinical trial with an additional calibration group. Setting: A regional referral center. Patients: Forty-five consecutive patients undergoing laparoscopic cholecystectomy who developed hemodynamic changes on induction of positive-pressure pneumoperitoneum were randomized to 3 groups. Interventions: Low-pressure, nonsequential pneumatic compression sleeves, wrapped around the legs, were used to equilibrate the pressure gradient in the study group and to gradually exceed it in the calibration group. In the control group, no sleeves were used. Main Outcome Measures: Transesophageal Dop-pler cardiac output, stroke volume, and systemic vascular resistance were monitored noninvasively. Results: The creation of positive-pressure pneumoperitoneum caused a significant decrease of cardiac output and stroke volume and increased systemic vascular resistance. In the experimental groups of patients, pressurizing the sleeves to the pneumoperitoneal pressure caused a significant increase of cardiac output (from 4.82 to 6.74 L/min), increased stroke volume, and decreased systemic vascular resistance (PϽ.001). This was not seen in the control group. Additional gradual pressure increase in the sleeves of the calibration group produced no further improvement. Releasing the pressure abolished the hemodynamic advantages. Conclusions: Applying pressure on the legs equivalent to the positive-pressure pneumoperitoneum improves hemodynamic performance during pneumoperitoneum by nullifying the pressure gradient that is responsible for the adverse consequences. This might be of major practical value, especially for cardiac patients undergoing prolonged laparoscopic operations.

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Overcoming Reduced Hepatic and Renal Perfusion Caused by Positive-Pressure Pneumoperitoneum

Bickel¹

2007

Arch Surg

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Correlation of peripheral venous pressure and central venous pressure in surgical patients

Cited by 86 publications

References 10 publications

Can peripheral venous pressure be an alternative to central venous pressure during right hepatectomy in living donors?

Can peripheral venous pressure be an alternative to central venous pressure during right hepatectomy in living donors?

Reversal of Adverse Hemodynamic Effects of Pneumoperitoneum by Pressure Equilibration

Overcoming Reduced Hepatic and Renal Perfusion Caused by Positive-Pressure Pneumoperitoneum

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