Effect of backrest on central venous pressure in pediatric cardiac surgery.

Following cardiac surgery in children, accurate monitoring of right ventricular function, as reflected by central venous pressure (CVP) or right atrial pressure, is crucial. Positioning the child supine has been considered necessary to achieve an accurate CVP reading. In this study the effect of backrest elevation on CVP readings in children following cardiac surgery was explored. The sample consisted of 40 children, 1 day to 9 years of age, who had undergone cardiac surgery within the previous 72 hours. CVP measurements at 0- and 30-degree backrest elevations were obtained hourly for 8 hours for each child. CVP readings were not significantly altered by the bedrest elevation. These findings suggest children may remain elevated for CVP readings rather than being awakened and repositioned to a 0-degree backrest elevation. For children who have nasogastric feedings, respiratory insufficiency, or increased intracranial pressure, a 30-degree backrest elevation may be maintained for the CVP reading, as well as for the children's safety and comfort.