Abstract :
Background: Central venous pressure (CVP) measurement is a reliable method for evaluating intravascular volume status
and cardiac function, but it is an invasive method that results in some well known complications. To compare CVP with
peripheral venous pressure (PVP) transduced from a peripheral intra venous catheter and to assess the reliability of
peripheral venous pressure (PVP) as a predictor of central venous pressure (CVP) in the setting of rapidly fluctuating
hemodynamics during neurosurgical procedures. Methods: Twenty five adult patients with ASA 1and 2 undergoing
craniotomy procedures lasting more than three hours were studied in this prospective clinical trial. A subclavian central vein
catheter and a 18-G peripheral intravenous catheter over forearm dedicated to measuring PVP were placed in all patients
after standard general endotracheal anaesthesia induction and institution of mechanical ventilation. Peripheral venous
pressure and CVP were recorded every 5 minutes and/or during predetermined, well-defined surgical events.
Simultaneous invasive mean arterial pressure, urine output were also monitored. Results: Peripheral venous pressure
correlated highly with CVP in every patient, and the overall correlation among all patients calculated using a random-effects
regression model was r = 0.893 ( P b 0.0001). A Bland-Altman analysis used to determine the accuracy of PVP in
comparison to CVP yielded a bias of - 4.12 mmHg and a precision of 1.99 mmHg. Conclusion: Our study confirms that
PVP correlates with CVP even under adverse hemodynamic conditions in patients undergoing major neurosurgical
procedures.
Keyword :
Central Venous Pressure, Neurosurgical Procedures, Venous Pressure.