Measurement of Central Venous Pressure From a Peripheral Intravenous Catheter Following Cardiopulmonary Bypass in Infants and Children With Congenital Heart Disease

Abstract

The current study evaluates the feasibility and accuracy of measuring central venous pressure from a peripheral intravenous catheter following cardiopulmonary bypass in infants and children. Central venous pressure was simultaneously measured from a right atrial catheter and from a peripheral intravenous cannula. The continuity of the peripheral intravenous cannula with the central venous system was evaluated by noting the change in the pressure during a sustained inspiratory effort and during occlusion of the vessel above (proximal to) the catheter. The cohort for the study included 29 infants and children. In 5 of the 29 patients (17%), there was no increase in the peripheral venous pressure in response to a Valsalva maneuver or occlusion of the extremity proximal to the intravenous site. The difference between peripheral venous pressure and central venous pressure in these patients was 11 +/- 3 mm Hg versus 2 +/- 1 mm Hg in the patients in whom the peripheral venous pressure increased with these maneuvers (P < .0001). No clinically significant variation in the accuracy of the technique was noted based on the actual CVP value, size of the PIV, its location, or the patient's weight. Provided that the peripheral venous pressure increases to a sustained inspiratory breath and occlusion above the intravenous site, there is a clinically useful correlation between the peripheral venous pressure and the central venous pressure following cardiopulmonary bypass in infants and children with congenital heart disease.