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. 2015 Nov;19(11):648-54.
doi: 10.4103/0972-5229.169338.

Correlation between central venous pressure and peripheral venous pressure with passive leg raise in patients on mechanical ventilation

Dharmendra Kumar  1 , Syed Moied Ahmed  1 , Shahna Ali  1 , Utpal Ray  2 , Ankur Varshney  1 , Kashmiri Doley  1
Affiliations

Correlation between central venous pressure and peripheral venous pressure with passive leg raise in patients on mechanical ventilation

Dharmendra Kumar et al. Indian J Crit Care Med. 2015 Nov.

Abstract

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 cmH2O. However, the correlation was good when the CVP was >10 cmH2O. 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.

Keywords: Central venous pressure; correlation; mechanical ventilation; passive leg raise; peripheral venous pressure.

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Figures

Figure 1
Figure 1
Correlation between central venous pressure and PVP values (r = 0.479)
Figure 2
Figure 2
Bias plotting of central venous pressure and PVP values at baseline (no fluid challenge)
Figure 3
Figure 3
Correlation between central venous pressure and PVP values of group A (r = 0.843) at baseline
Figure 4
Figure 4
Correlation between central venous pressure and PVP values of group B (r = 0.092) at baseline
Figure 5
Figure 5
Bias plotting of central venous pressure and PVP of group A at baseline (no fluid challenge)
Figure 6
Figure 6
Bias plotting of central venous pressure and PVP of group B at baseline (no fluid challenge)
Figure 7
Figure 7
The correlation between central venous pressure and PVP after applying fluid challenge by passive leg raise of 45°
Figure 8
Figure 8
Bias plotting of central venous pressure and PVP values after passive leg raise of 45°
Figure 9
Figure 9
The correlation between central venous pressure and PVP of group A after passive leg raise of 45° (r = 0.766)
Figure 10
Figure 10
The correlation between central venous pressure and PVP of group B after passive leg raise of 45° (r = 0.038)
Figure 11
Figure 11
Bias plotting of central venous pressure and PVP values of group A after passive leg raise of 45°
Figure 12
Figure 12
Bias plotting of central venous pressure and PVP values of group B after passive leg raise of 45°
See this image and copyright information in PMC

References

    1. Schroeder RA, Barbeito A, Bar-Yosef S, Mark JB. Miller's Anesthesia. 7th ed. New York: Churchill Livingstone Inc; 2009.
    1. 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. - PubMed
    1. 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. - PubMed
    1. 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. - PMC - PubMed
    1. 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. - PubMed