Infradiaphragmatic central venous pressures reflect supradiaphragmatic pressures in stable burn patients.
OBJECTIVE
Because the skin of the groin is often spared, femoral central venous catheters are sometimes used in patients with extensive burns. The accuracy of central venous pressures obtained from the infradiaphragmatic location relative to the traditional supradiaphragmatic value is not known in this population.


METHODS
Seventeen seriously injured but hemodynamically stable burn patients were enrolled in a protocol approved by the human studies committee in which, during scheduled central venous line rotations, supradiaphragmatic and infradiaphragmatic central venous pressures were determined simultaneously.


RESULTS
These 17 patients were an average of 21.8+/-20.1 years old (range, 6 months to 61 years), and the average burn size was 60.8+/-22.6% (range, 20 to 90%). Supradiaphragmatic and infradiaphragmatic pressures correlated well, with an r value of 0.903, p less than 0.01.


CONCLUSIONS
In the absence of clinically significant abdominal distention, infradiaphragmatic central venous pressure is an accurate reflection of supradiaphragmatic pressure, and indirectly, circulating blood volume.
Sheridan
R
R
Shriners Burns Hospital, Department of Surgery, Harvard Medical School, Boston, Massachusetts 02114, USA. sheridan.robert@mgh.harvard.edu
Nackel
A
A
Lydon
M
M
Petras
L
L
Basha
G
G
D000293:Adolescent; D000328:Adult; D001810:Blood Volume; D002056:Burns / Q000503:physiopathology*; D002405:Catheterization, Central Venous / Q000379:methods*; D002496:Central Venous Pressure; D002648:Child; D002675:Child, Preschool; D003964:Diaphragm; D006801:Humans; D007223:Infant; D008875:Middle Aged