Citation Information :
Kumar D, Ahmed SM, Ali S, Ray U, Varshney A, Doley K. Correlation between central venous pressure and peripheral venous pressure with passive leg raise in patients on mechanical ventilation. Indian J Crit Care Med 2015; 19 (11):648-654.
Background: Central venous pressure (CVP) assesses the volume status of patients. However, this technique is not without complications. We, therefore, measured peripheral venous pressure (PVP) to see whether it can replace CVP.
Aims: To evaluate the correlation and agreement between CVP and PVP after passive leg raise (PLR) in critically ill patients on mechanical ventilation.
Setting and Design: Prospective observational study in Intensive Care Unit.
Methods: Fifty critically ill patients on mechanical ventilation were included in the study. CVP and PVP measurements were taken using a water column manometer. Measurements were taken in the supine position and subsequently after a PLR of 45°. Statistical Analysis: Pearson′s correlation and Bland-Altman′s analysis.
Results: This study showed a fair correlation between CVP and PVP after a PLR of 45° (correlation coefficient, r = 0.479; P = 0.0004) when the CVP was <10 cmH 2 O. However, the correlation was good when the CVP was >10 cmH 2 O. Bland-Altman analysis showed 95% limits of agreement to be −2.912-9.472.
Conclusion: PVP can replace CVP for guiding fluid therapy in critically ill patients.
Schroeder RA, Barbeito A, Bar-Yosef S, Mark JB. Miller′s Anesthesia. 7 th ed. New York: Churchill Livingstone Inc.; 2009.
Murphy CV, Schramm GE, Doherty JA, Reichley RM, Gajic O, Afessa B, et al. The importance of fluid management in acute lung injury secondary to septic shock. Chest 2009;136:102-9.
Boyd JH, Forbes J, Nakada TA, Walley KR, Russell JA. Fluid resuscitation in septic shock: A positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med 2011;39:259-65.
Tagami T, Kushimoto S, Yamamoto Y, Atsumi T, Tosa R, Matsuda K, et al. Validation of extravascular lung water measurement by single transpulmonary thermodilution: Human autopsy study. Crit Care 2010;14:R162.
Fernández-Mondéjar E, Rivera-Fernández R, García-Delgado M, Touma A, Machado J, Chavero J. Small increases in extravascular lung water are accurately detected by transpulmonary thermodilution. J Trauma 2005;59:1420-3.
Monnet X, Anguel N, Osman D, Hamzaoui O, Richard C, Teboul JL. Assessing pulmonary permeability by transpulmonary thermodilution allows differentiation of hydrostatic pulmonary edema from ALI/ARDS. Intensive Care Med 2007;33:448-53.
Sakka SG, Klein M, Reinhart K, Meier-Hellmann A. Prognostic value of extravascular lung water in critically ill patients. Chest 2002;122:2080-6.
Amar D, Melendez JA, Zhang H, Dobres C, Leung DH, Padilla RE. Correlation of peripheral venous pressure and central venous pressure in surgical patients. J Cardiothorac Vasc Anesth 2001;15:40-3.
Munis JR, Bhatia S, Lozada LJ. Peripheral venous pressure as a hemodynamic variable in neurosurgical patients. Anesth Analg 2001;92:172-9.
Desjardins R, Denault AY, Bélisle S, Carrier M, Babin D, Lévesque S, et al. Can peripheral venous pressure be interchangeable with central venous pressure in patients undergoing cardiac surgery? Intensive Care Med 2004;30:627-32.
Anter AM, Bondok RS. Peripheral venous pressure is an alternative to central venous pressure in paediatric surgery patients. Acta Anaesthesiol Scand 2004;48:1101-4.
Hoftman N, Braunfeld M, Hoftman G, Mahajan A. Peripheral venous pressure as a predictor of central venous pressure during orthotopic liver transplantation. J Clin Anesth 2006;18:251-5.
Hadimioglu N, Ertug Z, Yegin A, Sanli S, Gurkan A, Demirbas A. Correlation of peripheral venous pressure and central venous pressure in kidney recipients. Transplant Proc 2006;38:440-2.
Charalambous C, Barker TA, Zipitis CS, Siddique I, Swindell R, Jackson R, et al. Comparison of peripheral and central venous pressures in critically ill patients. Anaesth Intensive Care 2003;31:34-9.
Tugrul M, Camci E, Pembeci K, Al-Darsani A, Telci L. Relationship between peripheral and central venous pressures in different patient positions, catheter sizes, and insertion sites. J Cardiothorac Vasc Anesth 2004;18:446-50.
Harvey MG, Cave G. Influence of tissue pressure on central venous pressure/peripheral venous pressure correlation: An experimental report. World J Emerg Med 2011;2:93-8.