Can we predict pulmonary wedge pressure from central venous pressure in hepatic transplantation?

Introduction

Volume infusion is the main therapeutic option to optimize preload and tissue oxygen supply in distributive shock. Pulmonary capillary wedge pressure (Pw) has been used as the most important variable to predict preload in unstable hemodynamic patients. However, most patients are not monitored with pulmonary artery catheters, making central venous pressure the preload variable of choice. The literature has shown a moderate correlation between Pw and central venous pressure (CVP) in septic patients. As far as we know there are no data about this correlation in the postoperative period of hepatic transplantation.

Objective

To evaluate the correlation between CVP and Pw in hepatic transplantation.

Materials and methods

Twelve postoperative hepatic transplantations were studied from January to November 2002. All analyses were performed 24 hours after surgery.

Results

We analyzed 69 simultaneous measurements and found a good correlation between CVP and Pw (Fig. 1).

Figure 1

Correlation between central venous pressure (CVP) and wedge pressure (Pw) in hepatic transplantation. R, Pearson correlation coefficient; R², Square Pearson correlation coefficient.

Conclusion

The CVP can be used to estimate Pw in the postoperative period of hepatic transplantation. Probably, CVP can be used as a preload variable to guide volume infusion in this group of patients.