Abstract
Objective
To determine the accuracy of meancontinuous central venous pressure (CVP) measurements in the abdominal vena cava.
Design
We simultaneously measured the CVP at the superior vena cava or right atrium and at the abdominal vena cava or common iliac vein. The study was conducted at the pediatric intensive care unit of a major university-affiliated medical center.
Patients
Nine patients, aged 6 months to 14 years, were included in our study.
Measurements and results
Elevencontinuous recordings of 12 to 68 min were taken, eight of them while the children were mechanically ventilated. Mean overall CVP ranged from 3 to 30 mmHg. A total of 519 simultaneous recordings were made, of which 515 (99.2%) were within the accepted limits of agreement of ±2 mmHg: 301 (58%) with ΔCVP of ±mmHg, 189 (36,4%) with ΔCVP of ±1 mmHg, and 25 (4.8%) with ΔCVP of ±2 mmHg. The mean pressure difference was −0.22±1.52 mmHg. Accuracy was maintained within all ranges of CVP (3–10, 11–20, and 21–30 mmHg) and was not influenced by mechanical ventilation or abdominal fluid colection.
Conclusion
In children with no obstruction of blood flow from the abdominal vena cava to the right atrium, the pressure in the abdominal vena cava or common iliac vein accurately reflects the pressure in the right atrium.
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References
Fleisher GR, Ludwig S (eds) (1988) Textbook of pediatric emergency medicine, 2nd edn. Williams and Wilkins, Baltimore, pp 1258–1259
Agarwal KC, Khan MAA, Jalla A, Amato JJ (1984) Cardiac perforation from central venous catheters: survival after cardiac tamponade in an infant. Pediatrics 73:333–338
Daniels SR, Hannon DW, Meyer RA, Kaplan S (1984) Paroxysmal supraventricular tachycardia: a complication of jugular central venous catheter in neonate. Am J Dis Child 134:474–475
Bagwell CE, Marchildon MB (1989) Mural thrombi in children: potentially lethal complication of central venous hyperalimentation. Crit Care Med 17: 295–296
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet I: 307–310
Rogers MC (ed) (1992) Textbook of peditric intensive care, 2nd edn. Williams and Wilkins, Baltimore, MD, pp 624–627
Anonymous (1989) Precautions necessary with central venous catheters. FDA Drug Bull 19:15–16
Berg RA, Lloyd TR, Donnerstein RL (1992) Accuracy of central venous pressure monitoring in the intra-abdominal inferior vena cava: a canine study. J Pediatr 120:67–71
Lloyd TR, Donnerstein RL, Berg RA (1992) Accuracy of central venous pressure measurement from the abdominal vena cava. Pediatrics 89:506–508
Howard IC, Michael AK, Victor CB (1994) Inferior vena cava pressure reliably predicts right atrial pressure in pediatric cardiac surgical patients. Crit Care Med 22:219–224
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Nahum, E., Dagan, O., Sulkes, J. et al. A comparison between continuous central venous pressure measurement from right atrium and abdominal vena cava or common iliac vein. Intensive Care Med 22, 571–574 (1996). https://doi.org/10.1007/BF01708098
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DOI: https://doi.org/10.1007/BF01708098