| Peripheral venous pressure as a predictor of central venous pressure during orthotopic liver transplantation. | |
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MedLine Citation:
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PMID: 16797425 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Nir Hoftman; Michelle Braunfeld; Gil Hoftman; Aman Mahajan |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Journal of clinical anesthesia Volume: 18 ISSN: 0952-8180 ISO Abbreviation: J Clin Anesth Publication Date: 2006 Jun |
Date Detail:
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Created Date: 2006-06-26 Completed Date: 2006-12-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8812166 Medline TA: J Clin Anesth Country: United States |
Other Details:
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Languages: eng Pagination: 251-5 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, David Geffen School of Medicine, UCLA Medical Center, Los Angeles, CA 90095-1778, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Catheterization, Peripheral Catheterization, Swan-Ganz Central Venous Pressure / physiology* Female Humans Liver Transplantation / physiology* Male Middle Aged Monitoring, Intraoperative Venous Pressure / physiology* |
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