Abstract
Introduction:A central venous pressure (CVP) measurement is used to assess intravascular status. Although this is usually accomplished by the placement of a central venous catheter (CVC), there are circumstances when placement may be technically difficult or impossible. The current study evaluates the feasibility of measuring CVP from a peripheral intravenous (IV) cannula in the prone position.Methods:CVP was simultaneously measured from a central venous catheter (CVC-P) and from a peripheral IV cannula (PVP). The continuity of the peripheral IV cannula with the central venous system was demonstrated by a change in the PVP during a sustained inspiratory effort.Results:The study cohort included 18 patients. All patients had 2 peripheral IV cannulae, and 10 PVP measurements were taken from each site. In 4 of the 36 cannulae (11%), there was no increase in the PVP in response to a sustained inspiratory effort. For these 4 cannulae, the PVP to CVC-P difference was 13 ± 4 mm Hg. In the 32 cannulae in which the PVP increased in response to a sustained inspiratory effort, the PVP to CVC-P difference was 2 ± 1 mm Hg (P < 0.0001), and the difference between the PVP and the CVC-P was ≤5 mm Hg in all of the sample sets. The accuracy of the technique did not vary based on the location of the peripheral cannula, its size, or the actual CVP reading.Conclusion:Provided that the PVP increases to a sustained inspiratory breath, there is a clinically useful correlation between the PVP and the actual CVP in the prone position.
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References
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