| Author |
Roger, C. Muller, L. Riou, B. Molinari, N. Louart, B. Kerbrat, H. Teboul, J-L Lefrant, J-Y |
| Description |
Country affiliation: France Author Affiliation: Roger C ( Division of Anesthesia Intensive Care Pain and Emergency, Nîmes University Hospital, Place de Professeur Robert Debré, Nîmes, 30029, France.); Muller L ( Faculty of Medicine, Montpellier-Nimes University I, Chemin du Carreau de Lane, Nîmes, 30000, France EA 2992, Chemin du Carreau de Lane, 30000 Nimes, France.); Riou B ( Burns, Trauma, and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia.); Molinari N ( Division of Anesthesia Intensive Care Pain and Emergency, Nîmes University Hospital, Place de Professeur Robert Debré, Nîmes, 30029, France.); Louart B ( Faculty of Medicine, Montpellier-Nimes University I, Chemin du Carreau de Lane, Nîmes, 30000, France EA 2992, Chemin du Carreau de Lane, 30000 Nimes, France.); Kerbrat H ( Institute of Cardiometabolism and Nutrition and Department of Emergency medicine and Surgery, Assistance Publique-Hôpitaux de Paris (APHP), Sorbonne Universités, UPMC Univ Paris 06, UMRS INSERM 1156, Paris, France.); Teboul JL ( PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier hospital, Montpellier cedex 5, 34295.); Lefrant JY ( Division of Anesthesia Intensive Care Pain and Emergency, Nîmes University Hospital, Place de Professeur Robert Debré, Nîmes, 30029, France.) |
| Abstract |
BACKGROUND: Several techniques exist for measuring central venous pressure (CVP) but little information is available about the accuracy of each method. The aim of this study was to compare different methods of CVP measurements in mechanically ventilated patients. METHODS: CVP was measured in mechanically ventilated patients without spontaneous breathing using four different techniques: 1) end expiratory CVP measurement at the base of the' c' wave (CVP ), chosen as the reference method; 2) CVP measurement from the monitor averaging CVP over the cardiac and respiratory cycles (CVP ); 3) CVP measurement after a transient withdrawing of mechanical ventilation (CVP ); 4) CVP measurement corrected for the transmitted respiratory pressure induced by intrinsic PEEP (calculated CVP: CVP ). Bias, precision, limits of agreement, and proportions of outliers (difference > 2 mm Hg) were determined. RESULTS: Among 61 included patients, 103 CVP assessments were performed. CVP bias [-0.87 (1.06) mm Hg] was significantly different from those of CVP [1.42 (1.07), P < 0.001 and CVP (1.04 (1.29), P < 0.001]. The limits of agreement of CVP [-2.96 to 1.21 mm Hg] were not significantly different to those of CVP (-1.49 to 3.57 mm Hg, P = 0.39) and CVP (-0.68 to 3.53 mm Hg, P = 0.31). The proportion of outliers was not significantly different between CVP (n = 5, 5%) and CVP (n = 9, 9%, P = 0.27) but was greater with CVP (n = 16, 15%, P = 0.01). CONCLUSIONS: In mechanically ventilated patients, CVP is a reliable method for assessing CVP Taking into account transmitted respiratory pressures, CVP had a higher proportion of outliers and precision than CVP . |
