Comparison of superior vena caval and femoroiliac venous pressure measurements during normal and inverse ratio ventilation.
OBJECTIVE
The aim of this study was to estimate the agreement between superior vena caval pressure (SVCP) and femoroiliac venous pressure (FIVP) measurements by using short (<20 cm) femoral catheters commonly used in an adult intensive care unit. In addition, the effects of two modes of ventilation on agreement were assessed.


METHODS
Measurements of central venous pressure were recorded from both sites by using the same pressure transducer connected to the catheters via a three-way stopcock. SVCP and FIVP were recorded at 5-min intervals for 40 mins with the patient in the supine position. Recordings were taken from ventilated patients during a randomized crossover sequence of normal and inverse ratio ventilation (IRV). Analyses included Pearson's correlation (r), intraclass correlation (ri), Bland-Altman plots, and repeated measures analysis of variance with crossover tests for period and period-treatment interactions.


METHODS
Adult intensive care unit.


METHODS
Adult intensive care patients.


METHODS
Central venous pressure.


RESULTS
Twenty-two patients were enrolled in the study, giving 162 paired measurements; r was .97 (p < .0001), and ri was .96. The bias for SVCP-FIVP measurements was -0.75 mm Hg (95% confidence interval = -1.31 to -0.18), with 95% limits of agreement of -3.30 to 1.81 mm Hg. Seventeen patients were suitable for randomization to normal ratio ventilation and IRV. IRV significantly increased SVCP and FIVP (p < .002). Tests for the effect of mode of ventilation on agreement (p = .36), for period (p = .26), and for period-treatment interaction (p = .84) were not significant.


CONCLUSIONS
The study showed excellent overall agreement with acceptable clinical agreement for SVCP and FIVP measurements that was not affected by changing the mode of ventilation. IRV significantly increased central venous pressure measurements from both catheter sites but had no effect on overall agreement.
Dillon
P J
PJ
Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, USA.
Columb
M O
MO
Hume
D D
DD
D000328:Adult; D000704:Analysis of Variance; D002496:Central Venous Pressure; D018592:Cross-Over Studies; D005268:Femoral Vein / Q000502:physiology*; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D015203:Reproducibility of Results; D012121:Respiration, Artificial / Q000379:methods*; D014683:Vena Cava, Superior / Q000502:physiology*