Rivas Doblado Jesús S, García Ubero Felipe, Artes León José Luis
Rev Enferm. 2002 Jan;25(1):51-4.
An accurate measure of central venous pressure has great clinical value; although at times due to causes inherent in the pathology of a patient this cannot be measured be the utmost conditions. The position a patient has in bed invariably affects the final measurement of central venous pressure in that patient. It is important to bear this in mind for patients who do not tolerate a supine position, such as those with polytraumatic injuries. The authors studied the variations in central venous pressure values taken on the same patient when he was in a supine position and when he had his bed inclined 45; the authors opted for an analytical study using 1061 measurements on patients checked into the intensive care ward at the Nuestra Señora de Fatima Clinic in Seville. The correct placement of the central catheter, either clavicle, jugular or "DRUM" placement, was confirmed by means of radiological testing in each of these patients. After obtaining these central venous pressure measurement values, the authors related these to the patient's corporal mass index, a comparison of weight in kilograms to height en square meters; they observed that when a patient's corporal volume is greater, greater is the difference between the measurements in a supine position and with bed inclined 45 degrees, in favor of the first measurement.
准确测量中心静脉压具有重要的临床价值；尽管有时由于患者病理状况的内在原因，在最理想的条件下也无法进行测量。患者在床上的体位始终会影响该患者中心静脉压的最终测量结果。对于不能耐受仰卧位的患者，如多发伤患者，牢记这一点很重要。作者研究了同一患者在仰卧位和床头抬高45度时中心静脉压值的变化；作者选择了一项分析性研究，对入住塞维利亚圣母法蒂玛诊所重症监护病房的患者进行了1061次测量。通过放射学检查确认了这些患者中每一位中心静脉导管的正确放置位置，无论是锁骨下、颈内还是“DRUM”放置。在获得这些中心静脉压测量值后，作者将这些值与患者的体质指数（体重千克数与身高平方米数之比）相关联；他们观察到，当患者的身体体积较大时，仰卧位测量值与床头抬高45度时测量值之间的差异就越大，且仰卧位测量值更高。
