Comparative study on central venous pressure evaluation in jugular or subclavian and femoral accesses

Objective

To compare central venous pressure (CVP) measurements obtained in two different locations (jugular or subclavian veins and femoral veins).

Setting

A 16-bed medical–surgical ICU.

Materials and methods

The patients enrolled had central venous catheters (CVC) in two different locations, one placed in the internal jugular or subclavian veins and a second in a femoral vein. Simultaneous measurements of CVP were undertaken by two different operators, with a pressure transducer zero-referenced at the mid-chest. Standard CVC with similar features (20 cm length) were used. Patients with intra-abdominal pressure (IAP) >15 mmHg were excluded. The IAP was previously evaluated in all patients using the method described by Sugrue and Hillman. A linear correlation analysis was performed, considering significant P > 0.05 and a correlation coefficient >0.85.

Results

Twenty four patients were studied and three patients were excluded. The mean age was 61.2 ± 9.3 years, the ICU stay was 9.8 ± 4.1 days, the APACHE II score was 24.8 ± 5.7, and SAPS II was 52.7 ± 10.4. The mean CVP measured with jugular or subclavian access was 12.1 ± 4.1 mmHg and 12.9 ± 4.2 mmHg at the femoral access. A good correlation between measurements was found with a correlation coefficient and P > 0.001.

Conclusion

CVP can be accurately measured in femoral accesses, using standard CVC in patients with normal intra-abdominal pressure.