Document Detail

Peripheral venous pressure as a predictor of central venous pressure during orthotopic liver transplantation.
MedLine Citation:
PMID:  16797425     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To assess the reliability of peripheral venous pressure (PVP) as a predictor of central venous pressure (CVP) in the setting of rapidly fluctuating hemodynamics during orthotopic liver transplant surgery. DESIGN: Prospective clinical trial. SETTING: UCLA Medical Center, main operating room-liver transplant surgery. PATIENTS: Nine adult patients with liver failure undergoing orthotopic liver transplant surgery. INTERVENTIONS: A pulmonary artery catheter and a 20-g antecubital peripheral intravenous catheter dedicated to measuring PVP were placed in all patients after standard general endotracheal anesthesia induction and institution of mechanical ventilation. MEASUREMENTS: Peripheral venous pressure and CVP were recorded every 5 minutes and/or during predetermined, well-defined surgical events (skin incision, venovenous bypass initiation, portal vein anastamosis, 5 minute post graft reperfusion, abdominal closure). Pulmonary artery pressure and cardiac output (via thermodilution) were recorded every 15 and 30 minutes, respectively. MAIN RESULTS: Peripheral venous pressure (mean +/- SD) was 11.0 +/- 4.5 mmHg vs a CVP of 9.5 +/- 5.0; the two measurements differed by an average of 1.5 +/- 1.6 mmHg. Peripheral venous pressure correlated highly with CVP in every patient, and the overall correlation among all nine patients calculated using a random-effects regression model was r = 0.95 (P < 0.0001). A Bland-Altman analysis used to determine the accuracy of PVP in comparison to CVP yielded a bias of -1.5 mmHg and a precision of +/-3.1 mm Hg. CONCLUSION: Our study confirms that PVP correlates with CVP even under adverse hemodynamic conditions in patients undergoing liver transplantation.
Nir Hoftman; Michelle Braunfeld; Gil Hoftman; Aman Mahajan
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  18     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-26     Completed Date:  2006-12-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  251-5     Citation Subset:  IM    
Department of Anesthesiology, David Geffen School of Medicine, UCLA Medical Center, Los Angeles, CA 90095-1778, USA.
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MeSH Terms
Catheterization, Peripheral
Catheterization, Swan-Ganz
Central Venous Pressure / physiology*
Liver Transplantation / physiology*
Middle Aged
Monitoring, Intraoperative
Venous Pressure / physiology*

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