Research

Annals of Intensive Care

, 2:21

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Comparison of superior vena cava and femoroiliac vein pressure according to intra-abdominal pressure

  • Hafid Ait-OufellaAffiliated withAP-HP, Hôpital Saint-Antoine, Service de réanimation médicaleInserm U970, Paris Research Cardiovascular CenterUniversité Pierre et Marie Curie-Paris 6Inserm U707Service de Réanimation médicale, Hôpital Saint-Antoine Email author 
  • , Pierre-Yves BoelleAffiliated withAP-HP, Hôpital Saint-Antoine, Service de santé publiqueUniversité Pierre et Marie Curie-Paris 6Inserm U707
  • , Arnaud GalboisAffiliated withAP-HP, Hôpital Saint-Antoine, Service de réanimation médicale
  • , Jean-luc BaudelAffiliated withAP-HP, Hôpital Saint-Antoine, Service de réanimation médicale
  • , Dimitri MargetisAffiliated withAP-HP, Hôpital Saint-Antoine, Service de réanimation médicale
  • , Mikael AlvesAffiliated withAP-HP, Hôpital Saint-Antoine, Service de réanimation médicale
  • , Georges OffenstadtAffiliated withAP-HP, Hôpital Saint-Antoine, Service de réanimation médicaleUniversité Pierre et Marie Curie-Paris 6Inserm U707
  • , Eric MauryAffiliated withAP-HP, Hôpital Saint-Antoine, Service de réanimation médicaleUniversité Pierre et Marie Curie-Paris 6Inserm U707
  • , Bertrand GuidetAffiliated withAP-HP, Hôpital Saint-Antoine, Service de réanimation médicaleUniversité Pierre et Marie Curie-Paris 6Inserm U707

Abstract

Background

Previous studies have shown a good agreement between central venous pressure (CVP) measurements from catheters placed in superior vena cava and catheters placed in the abdominal cava/common iliac vein. However, the influence of intra-abdominal pressure on such measurements remains unknown.

Methods

We conducted a prospective, observational study in a tertiary teaching hospital. We enrolled patients who had indwelling catheters in both superior vena cava (double lumen catheter) and femoroiliac veins (dialysis catheter) and into the bladder. Pressures were measured from all the sites, CVP, femoroiliac venous pressure (FIVP), and intra-abdominal pressure.

Results

A total of 30 patients were enrolled (age 62 ± 14 years; SAPS II 62 (52–76)). Fifty complete sets of measurements were performed. All of the studied patients were mechanically ventilated (PEP 3 cmH20 (2–5)). We observed that the concordance between CVP and FIVP decreased when intra-abdominal pressure increased. We identified 14 mmHg as the best intra-abdominal pressure cutoff, and we found that CVP and FIVP were significantly more in agreement below this threshold than above (94% versus 50%, P = 0.002).

Conclusions

We reported that intra-abdominal pressure affected agreement between CVP measurements from catheter placed in superior vena cava and catheters placed in the femoroiliac vein. Agreement was excellent when intra-abdominal pressure was below 14 mmHg.

Keywords

Intensive unit care Central venous pressure Superior vena cava Femoroiliac vena Intra-abdominal pressure