Effect of airway pressure on inferior vena cava pressure as a measure of central venous pressure in children☆,☆☆,★
Section snippets
METHODS
This study was approved by the appropriate human subject protection committees. The need for informed consent was waived by these institutional review boards. No interventions were done solely for the purpose of the study. All patients had had percutaneous placement of 4F 8 cm double-lumen catheters (Cook Critical Care, Bloomington, Ind.) into a femoral vein and into the SVC through either the internal jugular or subclavian veins. Multiple data points were collected at different levels of
RESULTS
Patients in group 1 ranged from 14 days to 16 years of age (mean, 4.3 years) with PRISM (pediatric risk of mortality) scores of 12 to 48 (mean, 26). Four patients from group 1 received ventilation from a high-frequency oscillator. Three of these patients also had data collected during periods of conventional ventilation. Patients in group 2 ranged from 7 months to 16 years of age (mean, 4.4 years) with PRISM scores of 12 to 42 (mean, 22). Measurements were obtained at 47 levels of PEEP (2 to 12
DISCUSSION
This study compared the effects of PEEP and MAP on the reliability of CVP as measured in the iliac vein in patients with and without abdominal distention. We have shown that high airway pressure (both PEEP and MAP) does not affect this pressure as a valid measure of CVP; the difference was always 3 mm Hg or less in group 1. The two measurements with a difference of 3 mm Hg occurred in one patient early in the study, and we cannot exclude the possibility that this patient was not completely
References (6)
- et al.
Percutaneous femoral venous catheterizations: a prospective study of complications
J PEDIATR
(1989) - et al.
Accuracy of central venous pressure monitoring in the intraabdominal vena cava: a canine study
J PEDIATR
(1992) - et al.
Percutaneous femoral venous catheterization in a pediatric intensive care unit: a survival analysis of complications
Crit Care Med
(1989)
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Intensivist Use of Hand-Carried Ultrasonography to Measure IVC Collapsibility in Estimating Intravascular Volume Status: Correlations with CVP
2009, Journal of the American College of SurgeonsCitation Excerpt :Earlier studies of IVC-CI and right atrial pressure in ventilated patients have shown variable results, leading to the preponderance of current evidence suggesting that this relationship is inconsistent in this group.30-33 Another factor that might have weakened the correlation between IVC-CI and CVP in our study is the high prevalence of increased intraabdominal pressures in SICU patients.34 Other factors that affect IVC diameters that might have been present in an unknown number of our patients include elevated pulmonary artery pressures, tricuspid or pulmonic valve disease, and right and left ventricular dysfunction.
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From the Departments of Pediatrics and Anesthesiology, University of California, Los Angeles, and Miller Children's Hospital, Long Beach, California
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Reprint requests: Victor C. Baum, MD, Department of Anesthesiology, Box 238, University of Virginia Medical Center, Charlottesville, VA 22908.
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0022-3476/95/$3.00 + 0 9/22/63483