Document Detail

Noninvasive central venous pressure measurement by controlled compression sonography at the forearm.
MedLine Citation:
PMID:  17936158     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to validate a new noninvasive technique to determine central venous pressure (CVP) using high-resolution compression sonography. BACKGROUND: Information concerning CVP is crucial in clinical situations, including cardiac failure, volume overload, and sepsis. The measurement of CVP, however, requires puncture of a vein with attendant risk of complication. METHODS: After a proof-of-concept study in healthy subjects, a prospective blinded evaluation was performed comparing CVP measurement using a central venous catheter with measurement using compression sonography in critically ill (intensive care unit) patients. RESULTS: In healthy subjects with experimentally induced venous hypertension with a wide range of pressure values, a strong correlation (r = 0.95; p < 0.001) between noninvasive and invasive peripheral venous pressure at the forearm was shown. High interobserver agreement with an intraclass correlation coefficient of 0.988 shows excellent reliability of the system. Noninvasive peripheral venous pressure measurement at the forearm showed a good correlation with CVP in 50 intensive care unit patients with the forearm positioned both below heart level (r = 0.84; p < 0.001) and at heart level (r = 0.85; p < 0.001). The mean difference between invasive and noninvasive measurement was negligible (-0.1 +/- 3.5 cm H2O and -0.7 +/- 3.4 cm H2O, respectively). CONCLUSIONS: Controlled-compression sonography is a valuable tool for measuring venous pressure in peripheral veins and allows reliable indirect assessment of CVP without intravenous catheterization.
Christoph Thalhammer; Markus Aschwanden; Angela Odermatt; Ulrich A Baumann; Stephan Imfeld; Deniz Bilecen; Stephan C Marsch; Kurt A Jaeger
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Publication Detail:
Type:  Journal Article; Validation Studies     Date:  2007-10-01
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  50     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-15     Completed Date:  2007-11-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1584-9     Citation Subset:  AIM; IM    
Department of Vascular Medicine, University Hospital, Basel, Switzerland.
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MeSH Terms
Aged, 80 and over
Blood Pressure Determination / methods*
Central Venous Pressure / physiology*
Critical Illness
Forearm / blood supply*,  ultrasonography*
Intensive Care Units
Linear Models
Middle Aged
Prospective Studies
Reproducibility of Results
Transducers, Pressure
Veins / ultrasonography*

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