Correlation of peripheral venous pressure and central venous pressure in surgical patients

Abstract

Objective: To determine the degree of agreement between central venous pressure (CVP) and peripheral venous pressure (PVP) in surgical patients. Design: Prospective study. Setting: University hospital. Participants: Patients without cardiac dysfunction undergoing major elective noncardiac surgery (n = 150). Measurements and Main Results: Simultaneous CVP and PVP measurements were obtained at random points in mechanically ventilated patients during surgery (n = 100) and in spontaneously ventilating patients in the postanesthesia care unit (n = 50). In a subset of 10 intraoperative patients, measurements were made before and after a 2-L fluid challenge. During surgery, PVP correlated highly to CVP (r = 0.86), and the bias (mean difference between CVP and PVP) was −1.6 ± 1.7 mmHg (mean ± SD). In the postanesthesia care unit, PVP also correlated highly to CVP (r = 0.88), and the bias was −2.2 ± 1.9 (mean ± SD). When adjusted by the average bias of −2, PVP predicted the observed CVP to within ±3 mmHg in both populations of patients with 95% probability. In patients receiving a fluid challenge, PVP and CVP increased similarly from 6 ± 2 to 11 ± 2 mmHg and 4 ± 2 to 9 ± 2 mmHg. Conclusion: Under the conditions of this study, PVP showed a consistent and high degree of agreement with CVP in the perioperative period in patients without significant cardiac dysfunction. PVP −2 was useful in predicting CVP over common clinical ranges of CVP. PVP is a rapid noninvasive tool to estimate volume status in surgical patients. Copyright © 2001 by W.B. Saunders Company