Peripheral venous pressure as a predictor of central venous pressure during orthotopic liver transplantation

Can peripheral venous pressure be an alternative to central venous pressure during right hepatectomy in living donors?

“…16 Recently, however, numerous studies have reported a strong correlation between CVP and PVP in various surgeries. 15,16,19,23,24 In a study performed by Hoftman et al, 19 a very high correlation between 2 pressures was observed in 9 patients undergoing orthotopic liver transplantation, but they noticed weaker CVP-PVP correlation at low filling pressures. On the contrary, Dessiris 23 reported that there was a good correlation between CVP and PVP in hypovolemic dogs even when CVP was as low as 0 mmHg and 2 pressures increased in parallel in response to fluid resuscitation.…”

“…Previously, some clinicians have introduced PVP, a simple and less invasive hemodynamic monitoring variable, as an alternative to CVP and found various correlations between them. [16][17][18][19][20][21][22] However, the use of PVP in place of CVP has not been widely advocated in the past because peripheral veins have valves that may interrupt the continuous column of blood and are thinwalled, and may be more easily subjected to compression and occlusion by the surrounding soft tissues. 21 In addition, external compression by the operator or blood pressure cuff and overstretching in the catheterized arm can occlude the peripheral vein and increase PVP, and muscle movement and shivering can be other sources of interference.…”

“…16 Some studies have concluded that PVP monitoring can accurately estimate CVP in most major surgeries such as cardiac surgeries and transplantations; however, large fluctuation of hemodynamics may require central vein access, not only for the purpose of CVP monitoring but also for rapid administration of fluids and drugs. 16,19,20 Recently, in many transplantation centers worldwide, the donor hepatectomy is performed on a routine basis and rarely associated with major bleeding necessitating massive transfusion complementary to advances in surgical skills. CVP monitoring is essentially unaffected during fluid infusion rate of 50 mL/hour or less.…”

“…[15][16][17] PVP reflects an "upstream" venous variable that is coupled to CVP by a continuous column of blood. 17 Some studies have reported a good correlation between CVP and PVP and the potential of PVP functioning as a predictor of CVP in various surgical patients, [16][17][18][19][20] whereas others have shown disagreement by indicating that PVP measurement does not give an accurate estimate of CVP and warned against this replacement. 21,22 Therefore, the aim of this study was to determine whether a clinically acceptable agreement or a reliable correlation between CVP and PVP exist and CVP can be replaced by PVP for right hepatectomy in living liver donors.…”

Non-invasive central venous pressure measurement by compression ultrasound—A step into real life

“…Several studies employing invasive and non invasive techniques showed a good correlation between peripheral venous pressure and CVP under a variety of study conditions in the operating room and the intensive care unit. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Basis for these studies is the fact, that in supine position pressure values within the cephalic, basilic and brachial veins are nearly identical to those of the superior vena cava. 4,5,19 Measurements of the inferior vena cava (IVC) diameter using ultrasound is frequently used to assess volume status of critically ill patients 20,21 , primarily distinguishing hypo-from iso-and hypervolemic conditions.…”