SITE OF CENTRAL VENOUS ACCESS IS NOT IMPORTANT FOR FLUID RESUSCITATION AND MONITORING

Authors

  • Muhammad Imran Ansari National Institute of Cardiovascular Diseases Karachi Pakistan
  • Jawed Abubaker Ziauddin Medical University Hospital Karachi Pakistan
  • Syed Zia Ullah National Institute of Cardiovascular Diseases Karachi Pakistan
  • Adeel Sohail Ziauddin Medical University Hospital Karachi Pakistan
  • Aziz Ur Rehman National Institute of Cardiovascular Diseases Karachi Pakistan
  • Shazia Ahmad National Institute of Cardiovascular Diseases Karachi Pakistan
  • Musa Karim National Institute of Cardiovascular Diseases Karachi Pakistan

Keywords:

Central venous pressure, Critical illness, Femoral vein, Intra-abdominal pressure, Superior vena cava

Abstract

Objective: To find the correlation between thoracic and femoral central venous pressure (CVP) and changes in femoral CVP, if any, incurred by intra-abdominal pressure.

Study Design: Cross sectional observational study.

Place and Duration of Study: Coronary care unit of National Institute of Cardiovascular Diseases Karachi, from Jul 2017 to Sep 2017.

Material and Methods: We randomly selected 90 patients who had a thoracic central catheter and another femoral catheter in place. A central venous pressure (CVP) pressure was recorded at both sites simultaneously with the same electronic transducer after zero calibration. An intra-abdominal pressure was also noted.

Results: Ninety patients participated in our study where mean age was 58.90 ± 11.34 years. The mean thoracic CVP was 11.22 ± 3.53 mmHg while mean femoral CVP was 11.38 ± 3.53 mmHg, with a mean pressure difference of -0.16 mmHg between the two. We also calculated intra-abdominal pressure with mean of 6.20 ± 2.47 mmHg. The reliability of the two methods was determined by intra class coefficient model where we got a higher value of 0.97 with significant p-value of <0.001. We analyzed the limits of agreement between the two approaches by Bland and Altman plot, where the mean difference between thoracic and femoral CVP was -0.16 mmHg (95 % CI - 0.34 - 0.02).

Conclusion: Central venous pressure can be reliably and accurately measured through femoral site.

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Published

25-06-2019

Issue

Section

Original Articles

How to Cite

1.
Ansari MI, Abubaker J, Ullah SZ, Sohail A, Rehman AU, Ahmad S, et al. SITE OF CENTRAL VENOUS ACCESS IS NOT IMPORTANT FOR FLUID RESUSCITATION AND MONITORING. Pak Armed Forces Med J [Internet]. 2019 Jun. 25 [cited 2024 Oct. 15];69(3):490-94. Available from: https://pafmj.org/PAFMJ/article/view/3014