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Avaliação não invasiva da pressão venosa central por ecocardiografia em cuidados intensivos – Particularidades nos doentes com dilatação do ventrículo direito e exacerbação de doença pulmonar crónica

Non invasive evaluation of central venous pressure using echocardiography in the intensive care – Specific features of patients with right ventricular enlargement and chronic exacerbated pulmonary disease
Authors: Marcelino, Paulo; Borba, Alexandra; Fernandes, Ana Paula; Marum, Susan; Germano, Nuno; Lopes, Mário G;

Avaliação não invasiva da pressão venosa central por ecocardiografia em cuidados intensivos – Particularidades nos doentes com dilatação do ventrículo direito e exacerbação de doença pulmonar crónica

Abstract

AbstractObjectives: To determine the possibility of non-invasive estimation of central venous pressure (CVP) through inferior vena cava (IVC) analysis, using transthoracic echocardiography (TTE).Design: A prospective 3-year study.Setting: A 16-bed medical/surgical Intensive Care Unit (ICU).Methods: Patients admitted to the ICU were enrolled. CVP measurement and TTE (determining cardiac chambers dimension and left ventricular shortening fraction) with IVC analysis (maximum dimension and IVC index) were performed simultaneously. Parametric and non-parametric statistical analysis was performed to establish correlations between variables. Results: 560 patients were admitted to the study, including 477 in whom IVC was analysed, aging 62.2±17.3years, a mean ICU stay 11.9±18.7days, a APACHE II score 23.9±8.9 and a SAPS II score 55.7±20.4. Through linear regression analysis CVP was influenced by IVC index (p=0.001), IVC maximum dimension (p=0.013) and presence of mechanical ventilation (p=0.002). A statistically significant correlation was found between the following parameters: an IVC index>25% and a CVP 7mmHg; an IVC maximum dimension10mmHg and CVP>7mmHg. Patients with right ventricle enlargement presented a lack of agreement between IVC maximum dimension and CVP7mmHg was also observed.Conclusions: IVC analysis is a possible way to noninvasively estimate CVP in a medical/surgical ICU. However, patients with right ventricular enlargement and admitted with chronic respiratory failure present a lack of agreement between IVC parameters and low values of CVP. IVC dimension is a marker of chronic disease and IVC index correlated better with CVP.Rev Port Pneumol 2006; XII (6): 637-658

Keywords

ecocardiografia, Pulmonary and Respiratory Medicine, Estudos Prospectivos, RC705-779, Hipertrofia Ventricular Direita, central venous pressure, doença pulmonar crónica, Doença Crónica, Doenças do Pulmão, Diseases of the respiratory system, Pressão venosa central, Echocardiography, Pressão Venosa Central, Determinação da Pressão Arterial, Cuidados Intensivos, chronic respiratory failure, inferior vena cava, Ecocardiografia, cuidados intensivos, intensive care

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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