Clinical and Experimental Circulation
Background and Goal of Study: Central venous catheters are associated with potential complications including arterial puncture, pneumothorax and development of infection. Peripheral venous pressure (PVP) through a peripheral venous cathether is technically easier and safer and has been suggested as an alternative to central venous pressure (CVP).1,2 We prospectively compared CVP and PVP in postoperative cardiac surgery patients at the intensive care unit.
Materials and Methods: Thirty-seven postoperative cardiac surgery patients were enrolled in the study. CVP and PVP were recorded simultaneously at random points in time. The data pairs were analyzed for correlation (Spearman's rank correlation), linear regression and agreement (Bland and Altman analysis corrected for repeated measurements). Values of P < 0.05 were considered statistically significant.
Results and Discussion: Ninety-one paired recordings of CVP and PVP were collected. The mean CVP (SD; range) was 9.1 mmHg (4.1; 4.0 to 21.0) and the mean PVP was 11.5 mmHg (4.9; 4.0 to 26.0) (P < 0.0005). Overall there was a strong positive correlation between PVP and CVP (r = 0.879; P < 0.0001). The linear regression equation showed that CVP = 0.71PVP + 0.88 (r2 = 0.736; P < 0.0001). The mean (SD) bias (PVP-CVP) was 2.4 (2.5) mmHg (P < 0.0001). Lower and upper limits of agreement (LOA) were -2.5 and 7.3 mmHg, respectively. Four of 91 points were outside the LOA. PVP showed a strong correlation with CVP although there was a statistically significant bias and relatively large LOA.
Conclusion(s): We conclude that although the two methods cannot be used interchangeably, PVP may be considered as a noninvasive alternative to CVP in postoperative cardiac surgery patients.
1. Intensive Care Med. 2004 Apr; 30(4): 627-32.
2. Anaesth Intensive Care. 2003 Feb; 31(1): 34-9.