title: Estimation of central venous pressure using inferior vena caval pressure from a femoral endovascular cooling catheter.
abstract: OBJECTIVE
  Endovascular cooling using the femoral cooling catheter is widely practiced. Central venous pressure (CVP) monitoring in patients undergoing femoral endovascular cooling may require the placement of another catheter near the right atrium (RA). We sought to estimate the agreement between the CVP recorded from catheters placed in the superior vena caval pressure (SVCP) and the inferior vena caval pressure (IVCP) recorded from the femoral cooling catheter in patients undergoing femoral endovascular cooling.
  
  
  METHODS
  We enrolled adult cardiac arrest survivors undergoing femoral endovascular cooling. A commercially available central venous catheter was placed in the SVC (superior vena cava) near the RA via subclavian venous access. Both SVCP and IVCP were recorded every 4 hours during therapeutic hypothermia. Arterial pressure, heart rate, peak inspiratory pressure (PIP), and positive end expiratory pressure (PEEP) at the time of vena caval pressure measurements were obtained.
  
  
  RESULTS
  A total of 323 pairs of SVCP and IVCP measurements were collected. The correlation coefficient between SVCP and IVCP was 0.965 (P < .001). The mean difference between SVCP and IVCP was -0.45 mm Hg (SD, 1.27; 95% confidence interval, -0.59 to -0.31 mm Hg). The limits of agreement were -2.94 to 2.05 mm Hg. Vena caval pressures were significantly correlated with airway pressures (peak inspiratory pressure and positive end expiratory pressure), whereas the difference between SVCP and IVCP did not correlate with airway pressures.
  
  
  CONCLUSIONS
  Inferior vena caval pressure measured via the femoral cooling catheter showed excellent agreement with CVP recorded from catheters placed in the SVC, which indicates that the femoral cooling catheter can be used for monitoring CVP.
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 501757, Gwangju, Republic of Korea.
authors.forename: Byung Kook
authors.initials: BK
authors.lastname: Lee
authors.forename: Hyoung Youn
authors.initials: HY
authors.lastname: Lee
authors.forename: Kyung Woon
authors.initials: KW
authors.lastname: Jeung
authors.forename: Yong Hun
authors.initials: YH
authors.lastname: Jung
authors.forename: Geo Sung
authors.initials: GS
authors.lastname: Lee
mesh_terms: D062905:Central Venous Catheters; D002496:Central Venous Pressure / Q000502:physiology*; D005260:Female; D005268:Femoral Vein; D006323:Heart Arrest / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000502:physiology*; D014683:Vena Cava, Superior / Q000502:physiology