Relationship between peripheral and central venous pressures in different patient positions, catheter sizes, and insertion sites.
OBJECTIVE
To investigate the relationship between peripheral and central venous pressures in different patient positions (supine, prone, lithotomy, Trendelenburg, and Fowler), different catheter diameters (18 G and 20 G), and catheterization sites (dorsal hand and forearm) during surgical procedures.


METHODS
Prospective clinical study.


METHODS
University hospital.


METHODS
Five hundred adult patients.


METHODS
Peripheral over-the-needle intravenous catheters were placed in the dorsal hand or forearm. Central venous catheters were inserted via the internal jugular or subclavian vein after induction of anesthesia.


RESULTS
Simultaneous measurements of central and peripheral venous pressures were made during stable conditions at random time points in surgery; 1953 paired measurements were performed. Mean central venous pressure was 11 +/- 3.7 mmHg and peripheral venous pressure was 13 +/- 4 mmHg (p = 0.0001). The overall correlation between central venous and peripheral venous pressures was found to be statistically significant (r = 0.89, r(2) = 0.8, p = 0.0001). Mean difference between peripheral and central venous pressure was 2 +/- 1.8 mmHg. Ninety-five percent limits of agreement were 5.6 to -1.6 mmHg.


CONCLUSIONS
It has been assumed that replacing central venous pressure by peripheral venous pressure would cause problems in clinical interpretation. If the validity of this data is confirmed by further studies, the authors suggest that central venous pressure could be estimated by using regression equations to compare the 2 methods.
Tugrul
Mehmet
M
Department of Anaesthesiology, Istanbul University, Istanbul, Turkey. mtugrul@isbank.net.tr
Camci
Emre
E
Pembeci
Kamil
K
Al-Darsani
Ayman
A
Telci
Lütfi
L
D000328:Adult; D000768:Anesthesia, General; D001132:Arm / Q000098:blood supply*; D001794:Blood Pressure; D002404:Catheterization; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods; D002496:Central Venous Pressure; D006801:Humans; D007601:Jugular Veins; D016343:Monitoring, Intraoperative; D011187:Posture / Q000502:physiology*