Hadimioglu N, Ertug Z, Yegin A, Sanli S, Gurkan A, Demirbas A
Department of Anesthesiology and Intensive Care Medicine, Akdeniz University, School of Medicine, Antalya, Turkey.
Transplant Proc. 2006 Mar;38(2):440-2. doi: 10.1016/j.transproceed.2005.12.057.
Previous studies in adults have demonstrated a clinically useful correlation between central venous pressure (CVP) and peripheral venous pressure (PVP). The current study prospectively compared CVP measurements from a central versus a peripheral catheter in kidney recipients during renal transplantation.
With ethics committee approval and informed consent, 30 consecutive kidney recipients were included in the study. We excluded patients who had significant valvular disease or clinically apparent left ventricular failure. For each of 30 patients, CVP and PVP were measured on five different occasions. The pressure tubing of the transducer system was connected to the distal lumen of the central or to the peripheral venous catheter for measurements following induction of anesthesia, after induction, 1 hour after induction, reperfusion of the kidney, and the end of the operation, yielding 150 hemodynamic data points. Each hemodynamic measurement included heart rate, mean arterial pressure, mean CVP, and mean PVP determined at end-expiration.
The mean PVP was 13.5 +/- 1.8 mm Hg and the mean CVP was 11.0 +/- 1.5 mm Hg during surgery. The mean difference was 2.5 +/- 0.5 (P < .01). Repeated-measures analysis of variance indicated a highly significant relationship between PVP and CVP (P < .01) with a Pearson correlation coefficient of 0.97.
Under the conditions of this study, PVP showed a consistently high agreement with CVP in the perioperative period among patients without significant cardiac dysfunction.
既往针对成年人的研究已证实中心静脉压(CVP)与外周静脉压(PVP)之间存在具有临床实用价值的相关性。本研究前瞻性地比较了肾移植术中肾移植受者经中心静脉导管与外周静脉导管测得的CVP。
经伦理委员会批准并获得知情同意后,30例连续的肾移植受者纳入本研究。我们排除了患有严重瓣膜疾病或临床上明显存在左心室衰竭的患者。对于30例患者中的每一位,在五个不同时间点测量CVP和PVP。在麻醉诱导后、诱导后、诱导后1小时、肾脏再灌注时以及手术结束时,将换能器系统的压力管路连接至中心静脉导管的远端管腔或外周静脉导管以进行测量,从而获得150个血流动力学数据点。每次血流动力学测量均包括在呼气末测定的心率、平均动脉压、平均CVP和平均PVP。
手术期间平均PVP为13.5±1.8 mmHg,平均CVP为11.0±1.5 mmHg。平均差值为2.5±0.5(P<.01)。重复测量方差分析表明PVP与CVP之间存在高度显著的相关性(P<.01),Pearson相关系数为0.97。
在本研究条件下,对于无明显心脏功能障碍的患者,围手术期PVP与CVP始终具有高度一致性。