Monitoring: Equipment and Computers
Background and Goal of Study: Correlation of central venous pressure (CVP) and peripheral venous pressure (PVP) in ASA II-III patients after major surgery.
Materials and Methods: A prospective repeated measures study was performed on 16 patients in our postsurgical intensive care unit (ICU). All patients had peripheral venous lines and required CVP monitoring. CVP and PVP were measured pairwise every hour during the first 5 hours after surgery. If typical sinusoidal wave forms were not seen on PVP tracings, the patient was excluded from the study (n = 4). All patients were spontaneosly breathing and reclining with the head at 30°. The CVP was placed at the superior vena cava. The peripheral venous catheter were standard peripheral over-the-needle catheter of different sizes (20 to 14 gauge), and were placed at the forearm or hand.
Results and Discussions: All patients were ASA II-III required a postsurgical ICU because of major surgery and patient comorbidity. This preliminary results showed a good correlation during the first 5 hours after surgery: r1 = 0.8, r2 = 0.9, r3 = 0.85, r4 = 0.86, r5 = 0.88 respectively (p < 0.01).
The mean values and SD of PVC and PVP during the first 5 hours were: 1st: 6,69 (3) and 9,5 (3.8), 2nd: 7,25 (3.2) and 9.88 (3.5), 3rd 7,13 (3.8) and 9.13 (3.7), 4th 6.44(2.8) and 9.19(3.3), 5th 6.19(2.6) and 8.56 (2.8) respectively.
The bias (mean difference between CVP and PVP) during the first 5 hours was 2.5 (SD1.5) mmHg.
Conclusion(s): PVP measurement may be a noninvasive alternative for estimating PVC at the PACU, in spontaneously ventilating ASA II-III patients without significant cardiac dysfunction undergoing major surgery.
1 Amar et al. J Cardiothorac Vasc Anesth 2001; 15: 40-3.