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  • Title: Measurement of central venous pressure from a peripheral intravenous catheter in the prone position during spinal surgery.
    Author: Tobias JD.
    Journal: South Med J; 2009 Mar; 102(3):256-9. PubMed ID: 19204622.
    Abstract:
    INTRODUCTION: A central venous pressure (CVP) measurement is used to assess intravascular status. Although this is usually accomplished by the placement of a central venous catheter (CVC), there are circumstances when placement may be technically difficult or impossible. The current study evaluates the feasibility of measuring CVP from a peripheral intravenous (IV) cannula in the prone position. METHODS: CVP was simultaneously measured from a central venous catheter (CVC-P) and from a peripheral IV cannula (PVP). The continuity of the peripheral IV cannula with the central venous system was demonstrated by a change in the PVP during a sustained inspiratory effort. RESULTS: The study cohort included 18 patients. All patients had 2 peripheral IV cannulae, and 10 PVP measurements were taken from each site. In 4 of the 36 cannulae (11%), there was no increase in the PVP in response to a sustained inspiratory effort. For these 4 cannulae, the PVP to CVC-P difference was 13 +/- 4 mm Hg. In the 32 cannulae in which the PVP increased in response to a sustained inspiratory effort, the PVP to CVC-P difference was 2 +/- 1 mm Hg (P < 0.0001), and the difference between the PVP and the CVC-P was <or=5 mm Hg in all of the sample sets. The accuracy of the technique did not vary based on the location of the peripheral cannula, its size, or the actual CVP reading. CONCLUSION: Provided that the PVP increases to a sustained inspiratory breath, there is a clinically useful correlation between the PVP and the actual CVP in the prone position.
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