title: Can non-invasive ventilation modify central venous pressure? Comparison between invasive measurement and ultrasonographic evaluation.
abstract: Central venous pressure (CVP) is primarily measured to assess intravascular volume status and heart preload. In clinical practice, the measuring device most commonly used in emergency departments and intensive care units, is an electronic transducer that interconnects a central venous catheter (CVC) with a monitoring system. Non-invasive ventilation (NIV) consists in a breathing support that supplies a positive pressure in airways through a mask or a cask though not using an endotracheal prosthesis. In emergency settings, non-invasive ultrasonography evaluation of CVP, and hence of intravascular volume status entail the measurement by a subxiphoid approach of inferior vena cava diameter and its variations in relation to respiratory activity. In the literature, there are many studies analyzing the ability to estimate CVP through ultrasonography, rating inspiratory and expiratory vena cava diameters and their ratio, defined as inferior vena cava collapsibility index (IVC-CI). At the same time, the effects of invasive mechanical ventilation on blood volume and the correlation during ventilation between hemodynamic invasive measurement of CVP and inferior vena cava diameters have already been demonstrated. Nevertheless, there are no available data regarding the hemodynamic effects of NIV and the potential correlations during this kind of ventilation between invasive and non-invasive CVP measurements. Therefore, this study aims to understand whether there exists or not an interrelationship between the values of CVP assessed invasively through a CVC and non-invasively through the IVC-CI in patients with severe respiratory distress, and above all to evaluate if these means of assessment can be influenced using NIV.
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy. zanomau@libero.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zanobetti
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Prota
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Coppa
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Sofia
authors.initials: S
authors.lastname: Bigiarini
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Peiman
authors.initials: P
authors.lastname: Nazerian
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Innocenti
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Conti
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Trausi
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Vanni
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pepe
authors.affiliation: Emergency Department, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000379:methods / Q000592:standards; D002496:Central Venous Pressure / Q000502:physiology*; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D063087:Noninvasive Ventilation / Q000009:adverse effects* / Q000379:methods*; D019095:Point-of-Care Systems / Q000592:standards; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods*
keywords: Central venous pressure; Emergency medicine; Emergency ultrasonography; Non-invasive ventilation