title: Iliac venous pressure estimates central venous pressure after laparotomy.
abstract: BACKGROUND
  Central venous pressure (CVP) is traditionally obtained through subclavian or internal jugular central catheters; however, many patients who could benefit from CVP monitoring have only femoral lines. The accuracy of illiac venous pressure (IVP) as a measure of CVP is unknown, particularly following laparotomy.
  
  
  METHODS
  This was a prospective, observational study. Patients who had both internal jugular or subclavian lines and femoral lines already in place were eligible for the study. Pressure measurements were taken from both lines in addition to measurement of bladder pressure, mean arterial pressure, and peak airway pressure. Data were evaluated using paired t-test, Bland-Altman analysis, and linear regression.
  
  
  RESULTS
  Measurements were obtained from 40 patients, 26 of which had laparotomy. The mean difference between measurements was 2.2 mm Hg. There were no significant differences between patients who had laparotomy and nonsurgical patients (P = 0.93). Bland-Altman analysis revealed a bias of 1.63 ± 2.44 mm Hg. There was no correlation between IVP accuracy and bladder pressure, mean arterial pressure, or peak airway pressure.
  
  
  CONCLUSIONS
  IVP is an adequate measure of CVP, even in surgical patients who have had recent laparotomy. Measurement of IVP to guide resuscitation is encouraged in patients who have only femoral venous catheter access.
authors.affiliation: Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Boone
authors.affiliation: Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Kirk
authors.affiliation: Department of Critical Care, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Nikia
authors.initials: N
authors.lastname: Tucker
authors.affiliation: Department of Critical Care, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Scott
authors.initials: S
authors.lastname: Gunn
authors.affiliation: Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address: forsytherm@upmc.edu.
authors.forename: Raquel
authors.initials: R
authors.lastname: Forsythe
mesh_terms: D002405:Catheterization, Central Venous / Q000379:methods*; D002496:Central Venous Pressure / Q000502:physiology*; D005260:Female; D005268:Femoral Vein; D006801:Humans; D007084:Iliac Vein / Q000502:physiology*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011182:Postoperative Care / Q000379:methods*; D011312:Pressure; D011446:Prospective Studies; D001743:Urinary Bladder / Q000502:physiology; D014682:Vena Cava, Inferior / Q000502:physiology
keywords: Central venous pressure; Iliac venous pressure; Inferior vena cava pressure