TY - JOUR
T1 - Central venous pressure and ultrasonographic measurement correlation and their associations with intradialytic adverse events in hospitalized patients
T2 - A prospective observational study
AU - Sekiguchi, Hiroshi
AU - Seaburg, Luke A.
AU - Suzuki, Jun
AU - Astorne, Walter J.
AU - Patel, Anil S.
AU - Keller, A. Scott
AU - Gajic, Ognjen
AU - Kashani, Kianoush B.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/4
Y1 - 2018/4
N2 - Purpose: To investigate correlation of central venous pressure (CVP) with ultrasonographic measurement of central veins, along with association between these variables and occurrence of intradialytic adverse events in hospitalized patients. Materials and methods: Patients requiring hemodialysis via dialysis catheter were prospectively enrolled. CVP measurements through catheter, internal jugular vein aspect ratio, subclavian vein collapsibility, inferior vena cava (IVC) maximal diameter, and IVC collapsibility were recorded before and after hemodialysis. Predictive accuracy of ultrasonographic measurements in discriminating high versus low CVP and their association with intradialytic adverse events were evaluated. Area under receiver operating characteristic curves (AUCs) were calculated. Results: Fifty-nine patients were enrolled. Median (interquartile range) pre- and post-dialysis CVPs were 8 (4–13) mm Hg and 6 (3–10) mm Hg, respectively (P < 0.01). In pre-dialysis, IVC collapsibility had the highest AUC (0.79, P < 0.01) to predict CVP > 8 mm Hg. In post-dialysis, IVC maximal diameter had the highest AUC (0.86, P < 0.01) to predict CVP ≤ 4 mm Hg. Fifteen patients (25%) had adverse events. Neither pre-dialytic CVP nor ultrasonographic variables were associated with occurrence of adverse events. Conclusions: Highest accuracy in predicting low and high CVP was observed with ultrasonographic assessment of IVC diameter and collapsibility. Adverse events were not predicted by pre-dialytic CVP or ultrasonographic measurements.
AB - Purpose: To investigate correlation of central venous pressure (CVP) with ultrasonographic measurement of central veins, along with association between these variables and occurrence of intradialytic adverse events in hospitalized patients. Materials and methods: Patients requiring hemodialysis via dialysis catheter were prospectively enrolled. CVP measurements through catheter, internal jugular vein aspect ratio, subclavian vein collapsibility, inferior vena cava (IVC) maximal diameter, and IVC collapsibility were recorded before and after hemodialysis. Predictive accuracy of ultrasonographic measurements in discriminating high versus low CVP and their association with intradialytic adverse events were evaluated. Area under receiver operating characteristic curves (AUCs) were calculated. Results: Fifty-nine patients were enrolled. Median (interquartile range) pre- and post-dialysis CVPs were 8 (4–13) mm Hg and 6 (3–10) mm Hg, respectively (P < 0.01). In pre-dialysis, IVC collapsibility had the highest AUC (0.79, P < 0.01) to predict CVP > 8 mm Hg. In post-dialysis, IVC maximal diameter had the highest AUC (0.86, P < 0.01) to predict CVP ≤ 4 mm Hg. Fifteen patients (25%) had adverse events. Neither pre-dialytic CVP nor ultrasonographic variables were associated with occurrence of adverse events. Conclusions: Highest accuracy in predicting low and high CVP was observed with ultrasonographic assessment of IVC diameter and collapsibility. Adverse events were not predicted by pre-dialytic CVP or ultrasonographic measurements.
KW - Central venous pressure
KW - Dry weight
KW - Hemodialysis
KW - Intradialytic adverse events
KW - Ultrasonography
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U2 - 10.1016/j.jcrc.2017.10.039
DO - 10.1016/j.jcrc.2017.10.039
M3 - Article
C2 - 29132056
AN - SCOPUS:85042486695
SN - 0883-9441
VL - 44
SP - 168
EP - 174
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -