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The role of femoral venous pressure and femoral venous oxygen saturation in the setting of intra-abdominal hypertension: a pig model.
MedLine Citation:
PMID:  20938378     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Femoral venous access is frequently used in critically ill patients. Because raised intra-abdominal pressure (IAP) is also frequently found in this group of patients, we examined the impact of IAP and positive end-expiratory pressure (PEEP) on femoral venous pressure (FVP) and femoral venous oxygen saturation (Sfvo2) in an animal model. Thirteen adult pigs received standardized anesthesia and ventilation. Randomized levels of IAP (3 [baseline], 18, and 26 mmHg) were applied, with levels of PEEP (5, 8, 12, and 15 cmH2O) applied randomly at each IAP level. We measured bladder pressure (IAP), superior vena cava pressure, pulmonary artery pressure, pulmonary artery occlusion pressure, FVP, mixed venous oxygen saturation (Svo2), and Sfvo2. We found that FVP correlated well with IAP (FVP = 4.1 + [0.12 × PEEP] + [1.00 × IAP]; R = 0.89, P < 0.001) with a moderate bias and precision of 5.0 and 3.8 mmHg, respectively. Because the level of agreement did not meet the recommendations of the World Society of Abdominal Compartment Syndrome, FVP cannot currently be recommended to measure IAP, and further clinical trials are warranted. However, a raised FVP should prompt the measurement of the bladder pressure. Femoral venous oxygen saturation did correlate neither with Svo2 nor with abdominal perfusion pressure. Therefore, Sfvo2 is of no clinical use in the setting of raised IAP.
Authors:
Adrian Regli; Bart L De Keulenaer; Lisen E Hockings; Gabrielle C Musk; Brigit Roberts; Peter V van Heerden
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  35     ISSN:  1540-0514     ISO Abbreviation:  Shock     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  United States    
Other Details:
Languages:  eng     Pagination:  422-7     Citation Subset:  IM    
Affiliation:
*Intensive Care Unit, Sir Charles Gairdner Hospital, Nedlands; and †Intensive Care Unit, Fremantle Hospital, Fremantle, Perth, Western Australia; ‡Intensive Care Unit, Alfred Hospital, Prahran, Melbourne, Victoria; and §Department of Veterinary Anaesthesia, School of Veterinary and Biomedical Science, Murdoch, Perth, Western Australia, Australia.
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