Scott S S, Giuliano K K, Pysznik E, Elliott S, Welsh K, Delbuono N
Baystate Medical Center, Springfield, Mass., USA.
Am J Crit Care. 1998 Jan;7(1):60-3.
Measurements of central venous pressure are generally obtained through one of the three ports of centrally placed triple-lumen catheters. However, no scientifically based literature is available that guides clinical practice and indicates which of the lumens is most appropriate for obtaining these measurements.
To determine if a difference exists between measurements of central venous pressure obtained via the proximal, medial, and distal ports of a triple-lumen catheter.
Measurements of central venous pressure in 48 adult ICU patients were obtained via each of the three ports of a triple-lumen catheter. Catheters were placed in either the right or left subclavian vein or the right or left internal jugular vein. The flush system was single-transducer, trifurcated pressure tubing system. Data were evaluated for variation among the three ports of the catheter for readings taken at a single point.
A repeated-measures analysis of variance showed significant differences across port sites. Post hoc univariate F tests showed significant differences between the proximal and distal ports and between the medial and distal ports. In some patients, the difference between central venous pressure obtained from the distal port and pressure obtained from the proximal or the medial port may be clinically significant.
Because measurements of central venous pressure may not always be comparable for all three ports of a triple-lumen catheter, care should be taken to distinguish when changes in pressure readings are a result of a change in port site rather than in the patient's condition.
中心静脉压的测量通常通过中心放置的三腔导管的三个端口之一进行。然而，目前尚无基于科学的文献来指导临床实践并指出哪个腔最适合进行这些测量。
确定通过三腔导管的近端、中间和远端端口获得的中心静脉压测量值之间是否存在差异。
对48名成年重症监护病房患者通过三腔导管的三个端口分别测量中心静脉压。导管置于右或左锁骨下静脉或右或左颈内静脉。冲洗系统为单传感器、三叉压力管系统。对在单个点读取的导管三个端口之间的数据变化进行评估。
重复测量方差分析显示不同端口部位存在显著差异。事后单变量F检验显示近端和远端端口之间以及中间和远端端口之间存在显著差异。在一些患者中，从远端端口获得的中心静脉压与从近端或中间端口获得的压力之间的差异可能具有临床意义。
由于三腔导管的所有三个端口的中心静脉压测量值可能并不总是可比的，因此应注意区分压力读数的变化是由于端口部位的改变还是患者病情的改变。
