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Logo of aicSpringerOpen.comThis journalSubmit a manuscriptRegisterSpringerOpen.comAnnals of Intensive Care
 
Ann Intensive Care. 2012; 2: 21.
Published online 2012 June 28. doi:  10.1186/2110-5820-2-21
PMCID: PMC3424143
Copyright ©2012 Ait-Oufella et al.; licensee Springer.
Comparison of superior vena cava and femoroiliac vein pressure according to intra-abdominal pressure
Hafid Ait-Oufella,corresponding author1,2,4,5,6 Pierre-Yves Boelle,3,4,5 Arnaud Galbois,1 Jean-luc Baudel,1 Dimitri Margetis,1 Mikael Alves,1 Georges Offenstadt,1,4,5 Eric Maury,1,4,5 and Bertrand Guidet1,4,5
1AP-HP, Hôpital Saint-Antoine, Service de réanimation médicale, Paris, 75571 Cedex 12, France
2Inserm U970, Paris Research Cardiovascular Center, Paris, France
3AP-HP, Hôpital Saint-Antoine, Service de santé publique, Paris, F-75012, France
4Université Pierre et Marie Curie-Paris 6, Paris, France
5Inserm U707, Paris, F-75012, France
6Service de Réanimation médicale, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, Paris, 75571 cedex 12, France
corresponding authorCorresponding author.
Hafid Ait-Oufella: hafid.aitoufella/at/sat.aphp.fr; Pierre-Yves Boelle: py.boelle/at/gmail.com; Arnaud Galbois: galbois/at/gmail.com; Jean-luc Baudel: jean-luc.baudel/at/sat.aphp.fr; Dimitri Margetis: dimitri.margetis/at/free.fr; Mikael Alves: mikaelalves/at/ymail.com; Georges Offenstadt: georges.offenstadt/at/sat.aphp.fr; Eric Maury: eric.maury/at/sat.aphp.fr; Bertrand Guidet: bertrand.guidet/at/sat.aphp.fr
Received February 17, 2012; Accepted June 28, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
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.
Methods
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.
Results
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).
Conclusions
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.
Keywords: Intensive unit care, Central venous pressure, Superior vena cava, Femoroiliac vena, Intra-abdominal pressure
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