Abstract
ObjectivesThe objective of this exploratory study was to find out the correlation of femoral vein diameter (FVD) to central venous pressure (CVP) measurements and to derive a prediction equation to help ascertain the fluid volume status in a critical patient.Patients and methodsThis was a single-centered prospective cohort study designed and conducted by the critical care department of Shifa International hospital in Islamabad, Pakistan. Patients were enrolled from the medical and surgical intensive care units. The inclusion criteria consisted of patients > 18 years of age, and an intrathoracic central venous catheterization (CVC) in place for producing CVP waveform through the transducer. Patients having contraindications to CVP placement and those unable to lie supine were excluded from the study. Critical Care fellows with sufficient training in performing venous ultrasonography measured the FVD. They were blinded to the CVP values of the same patients.ResultsThe study included 108 patients. Among these 70/108 (64.8%) were males. Mean age was 53.85 (SD=16.74). The CVP and femoral vein diameter were measured in all patients. Mean CVP was 9.89 cmH2O (SD=3.46) and mean femoral vein diameter was 0.92 cm (SD=0.27). Multiple regression was used to generate a prediction model. FVD, age and sex of the patient were used as predictor variables to predict CVP diameter. The model was statistically significant with a p-value of < 0.000 and an F-value of 104.806. R-squared value for this model came out to be 0.744, thus the model was able to explain about 74.4% of the variance in the values observed for CVP. When controlled for age and sex, FVD was found highly correlated with CVP diameter with a p-value of < 0.000. A regression equation was derived that can be used to generate predicted values of CVP in millimeters of mercury with an R-square of 0.745 if FVD in centimeters is provided; CVP (cmH2O) = -0.039 + 10.718* FVD.ConclusionsFVD was found highly correlated to CVP measurements and it suggests an alternate non-invasive method of ascertaining the volume status in the critically ill.
Highlights
Fluid volume status in the management of the critically ill has been the cornerstone of any effective therapy
The central venous pressure (CVP) and femoral vein diameter were measured in all patients
R-squared value for this model came out to be 0.744, the model was able to explain about 74.4% of the variance in the values observed for CVP
Summary
Fluid volume status in the management of the critically ill has been the cornerstone of any effective therapy. There are two available options to ascertain the volume status: invasive and noninvasive. There are some limitations for invasive volume status monitoring [1,2,3]. The current prevailing practices in intensive care units (ICUs) have been using central venous pressure (CVP) as a guide for fluid management; it is not the gold standard and sometimes is misleading [4]. Pulmonary artery catheterization has been the lesser employed invasive modality due to risks and the technical expertise it requires to monitor the fluid status, but studies have not proved any better outcome with it [5]. The common complications associated with pulmonary artery catheterization (PAC) are infection, thrombosis and vascular injury [2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
