Akademik Veri Yönetim Sistemi
Anestezi Dergisi, cilt.13, sa.1, ss.48-52, 2005 (Scopus)
Peripheral venous pressure (PVP) measurement has been suggested to be an alternative to central venous pressure (CVP) measurement in different clinical setups. Our aim was to determine the agreement between PVP and CVP measurements in critically ill patients and to define a subgroup of patients in which PVP can be used instead of CVP. Twenty-four hour simultaneous paired PVP and CVP measurements were recorded in 41 critically ill patients, using a central venous catheter and a peripheral venous catheter on the dorsum of the hand. The range of agreement was defined as mean bias±2SDc (corrected standard deviation for repeated measurements from the same individual) as described by Bland and Altman. According to this approach, patients were divided in two groups: a good agreement group and a poor agreement group. The mean CVP-PVP bias obtained from 908 measurement pairs was -6.77±4.81. In 94 (>10%) measurement pairs, the biases were outside the ±2SDc limits of agreement in 26 patients (poor agreement group). 15 patients had all the 24 CVP/PVP measurement pairs in good agreement (good agreement group). There was no difference between the two groups regarding demographic variables, APACHE II score on admission, PEEP administration, duration of mechanical ventilation and ICU stay. The patients who were admitted to the ICU with respiratory distress had better CVP/PVP agreement compared to patients with other admission diagnoses. There were also no differences between the two groups regarding vital functions and total fluid balance during the 24 hours of measurements. We concluded that PVP measurements might be an alternative to CVP measurements only in hemodynamically stable ICU patients with respiratory problems.