Correlation of Peripheral And Central Venous Pressure Values In Intensive Care Patients With Acute Renal Failure

Abstract

Objective

In this study, we aimed to analyze if there is any relationship between acute renal failure, central and peripheral venous pressure measurements in adult intensive care patients.

Materials and Methods

We included 39 patients (16 F, 73.6 ± 13.9 yrs old) who were hospitalized in intensive care unit (ICU) for at least 6 days for any reason. Basal and daily creatinine values, daily systolic, diastolic, and mean blood pressures, and central venous pressure / peripheral venous pressure (CVP/PVP) measurements were recorded. Patients who had more than 50% increase in creatinine levels during follow-up were accepted as acute kidney injury (AKI, n: 12) group while patients with stable creatinine values were accepted as no-AKI (n: 27) group.

Results

Considering all patients we found that PVP and CVP measurements were positively correlated (r:.882, p: 0.0001). Mean PVP was 10.6 ± 2.4, mean CVP was 6.4 ± 2.4 and mean PVP- CVP was 4.1 ± 1.1 mmHg. A Bland-Altman diagram for the comparison between mean CVP and PVP measurements during ICU hospitalization also indicated perfect agreement (difference of-4.3). AKI and no-AKI groups were similar in means of demographic characteristics. AKI group had both higher PVP (p: 0.009) and higher CVP (0.039) values. They also had lower systolic and mean arterial pressure (p < 0.05). Patients with renal failure has the highest CVP and PVP values and lowest blood pressures compared to noAKI patients (p: 0.01).

Conclusion

We think that PVP and CVP measurements are highly correlated and both could be used as early markers for venous congestion, lower arterial filling and ARF. 

Keywords

• Acute renal failure,peripheral venous pressure

Akut Böbrek Yetmezlikli Yoğun Bakım Hastalarında Periferal ve Santral Venöz Basınç Değerlerinin Korelasyonu

Öz

Amaç

Bu çalışmada yetişkin yoğun bakım ünitesindeki (YBÜ) hastalarda akut böbrek yetmezliği, santral ve periferik venöz basınç ölçümleri arasında herhangi bir ilişki olup olmadığını analiz etmeyi amaçladık.

Gereç ve Yöntem

Herhangi bir nedenle YBÜ’de en az 6 gün yatmış 39 hasta (16 K, 73.6 ± 13.9 yaş) dahil edildi. Bazal ve günlük kreatinin değerleri, günlük sistolik, diyastolik ve ortalama kan basınçları ile santral venöz basınç / periferik venöz basınç (CVP/ PVP) ölçümleri kaydedildi. İzlem sırasında kreatinin düzeylerinde %50’den fazla artış görülen hastalar, akut böbrek hasarı (AKI, n: 12) grubunda, stabil kreatinin değerleri olan hastalar ise no-AKI (n: 27) grup olarak kabul edildi.

Bulgular

Tüm hastalar göz önüne alındığında, PVP ve CVP ölçümlerinin pozitif yönde (r: .882, p: 0.0001) korele olduğunu tespit ettik. Ortalama PVP 10.6 ± 2.4, ortalama CVP 6.4 ± 2.4 ve ortalama PVP – CVP= 4.1 ± 1.1 mmHg idi. YBÜ’de yatış sürecinde ortalama CVP ve PVP ölçümleri arasındaki karşılaştırmada Bland-Altman diyagramı da mükemmel bir uyum (-4.3 farkı) olduğunu gösterdi. AKI ve no-AKI grupları demografik özellikler açısından benzerdi. AKI grubunda hem PVP (p: 0.009) hem de CVP (0.039) değerleri daha yüksekti. Ayrıca sistolik ve arteryal basınçları daha

düşüktü (p <0.05). Böbrek yetmezliği olan hastalar no-AKI hastalarına kıyasla en yüksek CVP ve PVP değerlerine ve en düşük kan basıncına sahip olduğu görüldü (p: 0.01).

Sonuç

PVP ve CVP ölçümlerinin yüksek oranda korelasyona sahip olduğunu ve her ikisinin de venöz konjesyon, düşük arteriyel dolum ve ARF için erken belirteçler olarak kullanılabileceğini

düşünüyoruz.

Anahtar Kelimeler

• Akut böbrek yetmezliği,periferik venöz basınç

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