AP-HP, Hôpital Saint-Antoine, Service de réanimation médicale, Paris, 75571 Cedex 12, France.
Ann Intensive Care. 2012 Jun 28;2(1):21. doi: 10.1186/2110-5820-2-21.
Previous studies have shown a good agreement between central venous pressure (CVP) measurements from catheters placed in superior vena cava and catheters placed in the abdominal cava/common iliac vein. However, the influence of intra-abdominal pressure on such measurements remains unknown.
We conducted a prospective, observational study in a tertiary teaching hospital. We enrolled patients who had indwelling catheters in both superior vena cava (double lumen catheter) and femoroiliac veins (dialysis catheter) and into the bladder. Pressures were measured from all the sites, CVP, femoroiliac venous pressure (FIVP), and intra-abdominal pressure.
A total of 30 patients were enrolled (age 62 ± 14 years; SAPS II 62 (52-76)). Fifty complete sets of measurements were performed. All of the studied patients were mechanically ventilated (PEP 3 cmH20 (2-5)). We observed that the concordance between CVP and FIVP decreased when intra-abdominal pressure increased. We identified 14 mmHg as the best intra-abdominal pressure cutoff, and we found that CVP and FIVP were significantly more in agreement below this threshold than above (94% versus 50%, P = 0.002).
We reported that intra-abdominal pressure affected agreement between CVP measurements from catheter placed in superior vena cava and catheters placed in the femoroiliac vein. Agreement was excellent when intra-abdominal pressure was below 14 mmHg.
先前的研究表明，放置在上腔静脉中的导管和放置在下腔静脉/髂总静脉中的导管测量的中心静脉压（CVP）之间具有良好的一致性。然而，腹内压对这种测量的影响尚不清楚。
我们在一家三级教学医院进行了一项前瞻性、观察性研究。我们招募了在上腔静脉（双腔导管）和股髂静脉（透析导管）以及膀胱中都有留置导管的患者。从所有部位测量压力，包括 CVP、股髂静脉压（FIVP）和腹内压。
共纳入 30 名患者（年龄 62±14 岁；SAPS II 62（52-76））。进行了 50 套完整的测量。所有研究患者均接受机械通气（PEP 3 cmH20（2-5））。我们观察到，当腹内压增加时，CVP 和 FIVP 之间的一致性降低。我们确定 14mmHg 为最佳腹内压临界值，发现低于该阈值时 CVP 和 FIVP 的一致性显著更高（94%比 50%，P=0.002）。
我们报告腹内压会影响从上腔静脉放置的导管和股髂静脉放置的导管测量的 CVP 之间的一致性。当腹内压低于 14mmHg 时，一致性非常好。
