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Estimation of central venous pressure using inferior vena caval pressure from a femoral endovascular cooling catheter.
MedLine Citation:
PMID:  22980367     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Endovascular cooling using the femoral cooling catheter is widely practiced. Central venous pressure (CVP) monitoring in patients undergoing femoral endovascular cooling may require the placement of another catheter near the right atrium (RA). We sought to estimate the agreement between the CVP recorded from catheters placed in the superior vena caval pressure (SVCP) and the inferior vena caval pressure (IVCP) recorded from the femoral cooling catheter in patients undergoing femoral endovascular cooling. METHODS: We enrolled adult cardiac arrest survivors undergoing femoral endovascular cooling. A commercially available central venous catheter was placed in the SVC (superior vena cava) near the RA via subclavian venous access. Both SVCP and IVCP were recorded every 4 hours during therapeutic hypothermia. Arterial pressure, heart rate, peak inspiratory pressure (PIP), and positive end expiratory pressure (PEEP) at the time of vena caval pressure measurements were obtained. RESULTS: A total of 323 pairs of SVCP and IVCP measurements were collected. The correlation coefficient between SVCP and IVCP was 0.965 (P < .001). The mean difference between SVCP and IVCP was -0.45 mm Hg (SD, 1.27; 95% confidence interval, -0.59 to -0.31 mm Hg). The limits of agreement were -2.94 to 2.05 mm Hg. Vena caval pressures were significantly correlated with airway pressures (peak inspiratory pressure and positive end expiratory pressure), whereas the difference between SVCP and IVCP did not correlate with airway pressures. CONCLUSION: Inferior vena caval pressure measured via the femoral cooling catheter showed excellent agreement with CVP recorded from catheters placed in the SVC, which indicates that the femoral cooling catheter can be used for monitoring CVP.
Authors:
Byung Kook Lee; Hyoung Youn Lee; Kyung Woon Jeung; Yong Hun Jung; Geo Sung Lee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-11
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  -     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
Affiliation:
Department of Emergency Medicine, Chonnam National University Hospital, 501757, Gwangju, Republic of Korea.
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