Peripheral venous pressure as a reliable predictor for monitoring central venous pressure in patients with burns

Abstract

Background:Optimizing cardiovascular function to ensure adequate tissue oxygen delivery is a key objective in the care of critically ill patients with burns. Hemodynamic monitoring may be necessary to optimize resuscitation in serious burn patients with reasonable safety. Invasive central venous pressure (CVP) monitoring has become the corner stone of hemodynamic monitoring in patients with burns but is associated with inherent risks and technical difficulties. Previous studies on perioperative patients have shown that measurement of peripheral venous pressure (PVP) is a less invasive and cost-effective procedure and can reliably predict CVP.Objective:The aim of the present prospective clinical study was to determine whether a reliable association exists between changes in CVP and PVP over a long period in patients admitted to the Burns Intensive Care Unit (BICU).Subjects and Methods:The CVP and PVP were measured simultaneously hourly in 30 burns patients in the BICU up to 10 consecutive hours. The predictability of CVP by monitoring PVP was tested by applying the linear regression formula and also using the Bland–Altman plots of repeated measures to evaluate the agreement between CVP and PVP.Results:The regression formula revealed a reliable and significant association between CVP and PVP. The overall mean difference between CVP and PVP was 1.628 ± 0.84 mmHg (P < 0.001). The Bland–Altman diagram also showed a perfect agreement between the two pressures throughout the 10 h period.Conclusion:Peripheral venous pressure measured from a peripheral intravenous catheter in burns patients is a reliable estimation of CVP, and its changes have good concordance with CVP over a long period of time.

Peripheral Venous Pressure: An Alternative to Central Venous Pressure?

“…The mean difference between the measurements varied from 2.72 (CI 2.1 to 3.3) to 2.92(CI 2.3 to 3.45) which were statistically significant. [12][13][14] .…”

Peripheral venous pressure to monitor fluid resuscitation in burns-more confusing than helpful?

“…The present study[ 2 ] describes a simple, inexpensive, and minimally invasive technique that can be used as a substitute to CVP and demonstrates the acceptable accuracy of PVP monitoring (the changes in CVP and PVP are strongly correlated and consistent over time). Considering that the clinical utility of CVP as a guide to diagnosis or therapy in critically ill patients continuous to be disputed; also considering the fact that PVP provides equivalent physiological information to CVP,[ 7 8 ] the clinical usefulness of PVP monitoring is questionable.…”

“…The present study evaluated the use of peripheral venous pressure (PVP) monitoring and demonstrated reliable agreement between central venous pressure (CVP) and PVP over a 10 h period, suggesting that PVP monitoring can be used as a simple, cost-effective, and less invasive substitute for CVP monitoring in patients admitted to the burns Intensive Care Unit. [ 2 ] This method may have potential implications for clinical situations where CVP is used for patient care decisions, in situations where central venous site is inaccessible and also to avoid the complications of central venous catheterization in critically ill burns patients.…”

Infusion therapy strategy for postpartum hemorrhage: what guidelines to choose?

“…Анализ волны при измерении периферического венозного давления с помощью стандартного внутривенного катетера может обеспечить недорогой, минимально инвазивный мониторинг у паци-ентов с интраоперационной кровопотерей. Анализ волны при измерении периферического венозного давления продемонстрировал большую чувствительность для обнаружения ранней гиповолемии (всего лишь при 6% кровопотери от ОЦК) по сравнению со стандартным мониторингом [60][61][62]. В акушерстве не проводились исследования, анализирующие периферическое венозное давление при ПРК.…”