Correlation between centrally versus peripherally transduced venous pressure in prone patients undergoing posterior spine surgery.
METHODS
Prospective clinical observational study.


OBJECTIVE
To evaluate the correlation and agreement between peripherally and centrally transduced venous pressures in prone spine surgery patients.


BACKGROUND
In view of a variety of potential complications associated with the placement of central venous lines for the purpose of central venous pressure (CVP) monitoring, a number of authors have suggested that the use of peripherally transduced pressures (PVP) instead may yield similar results. Data confirming the validity of this technique for the purpose of intravascular fluid volume monitoring in prone patients undergoing spine surgery remain scarce.


METHODS
After protocol approval by the internal review board, we enrolled 40 patients who underwent spine surgery in the prone position. CVP and PVP were recorded simultaneously. The data pairs were analyzed for correlation. Bland and Altman plots were created to evaluate the degree of agreement between the 2 modes of venous pressure monitoring.


RESULTS
A total of 1275 data pairs were collected. The mean PVP was 17.55 mm Hg +/- 4.93 mm Hg and the mean CVP 15.52 mm Hg +/- 4.77 mm Hg (P < 0.001), thus yielding a mean difference of 2.04 mm Hg +/- 1.39 mm Hg. PVP and CVP correlated well over a wide range of pressures (r = 0.949, r = 0.920 [P < 0.001]). A high level of agreement was found between both methods of venous pressure measurement.


CONCLUSIONS
CVP and PVP correlate well under conditions associated with prone spine surgery. With a high level of agreement found in this study, PVP may represent an attractive alternative to CVP monitoring to assess fluid volume trends intraoperatively.
Memtsoudis
Stavros G
SG
Departments of Anesthesiology, Division of Spine Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, NY 10021, USA. memtsoudiss@hss.edu
Jules-Elysse
Kethy
K
Girardi
Federico P
FP
Buschiazzo
Valeria
V
Maalouf
Daniel
D
Sama
Andrew A
AA
Urban
Michael K
MK
D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination / Q000379:methods; D002406:Catheterization, Peripheral / Q000379:methods*; D002496:Central Venous Pressure / Q000502:physiology*; D005260:Female; D006225:Hand / Q000098:blood supply / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D016684:Prone Position / Q000502:physiology*; D011446:Prospective Studies; D014690:Venous Pressure / Q000502:physiology