Relationship between peripheral and central venous pressures in different patient positions, catheter sizes, and insertion sites

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

“…Their study was performed in a wide variety of surgical patients (American Society of Anesthesiologists I-IV) and various surgical positions. 22 However, in our study, the limits of agreement of PVP-CVP was Ϫ1.03 to 3.34 mmHg, and these values were comparable to the clinically acceptable limits of agreement (Ϯ2 mm Hg). Therefore, our limits of agreement between PVP and CVP may be considered acceptable in most American Society of Anesthesiologists I or II donors undergoing right hepatectomy.…”

“…However, this conclusion came from the data of critically ill patients. Tugrul et al 22 also reported that PVP showed strong correlation with CVP and mean difference between PVP and CVP was 2 Ϯ 1.8 mmHg, but the upper limit of agreement of PVP-CVP (5.6 mmHg) indicated the difference between 2 pressures might reach a clinically unacceptable value. Their study was performed in a wide variety of surgical patients (American Society of Anesthesiologists I-IV) and various surgical positions.…”

“…Previously, some clinicians have introduced PVP, a simple and less invasive hemodynamic monitoring variable, as an alternative to CVP and found various correlations between them. [16][17][18][19][20][21][22] However, the use of PVP in place of CVP has not been widely advocated in the past because peripheral veins have valves that may interrupt the continuous column of blood and are thinwalled, and may be more easily subjected to compression and occlusion by the surrounding soft tissues. 21 In addition, external compression by the operator or blood pressure cuff and overstretching in the catheterized arm can occlude the peripheral vein and increase PVP, and muscle movement and shivering can be other sources of interference.…”

“…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.…”

“…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. 21,22 Therefore, the aim of this study was to determine whether a clinically acceptable agreement or a reliable correlation between CVP and PVP exist and CVP can be replaced by PVP for right hepatectomy in living liver donors.…”