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

  • 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
2019-06-25
How to Cite
Ansari, M., Abubaker, J., Ullah, S., Sohail, A., Rehman, A., Ahmad, S., & Karim, M. (2019). SITE OF CENTRAL VENOUS ACCESS IS NOT IMPORTANT FOR FLUID RESUSCITATION AND MONITORING. Pakistan Armed Forces Medical Journal (PAFMJ), 69(3), 490-94. Retrieved from https://pafmj.org/index.php/PAFMJ/article/view/3014
Section
Original Articles