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Correlations between pulmonary artery pressures and inferior vena cava collapsibility in critically ill surgical patients: An exploratory study.
Int J Crit Illn Inj Sci. 2016 Oct-Dec; 6(4):194-199.IJ

Abstract

INTRODUCTION

As pulmonary artery catheter (PAC) use declines, search continues for reliable and readily accessible minimally invasive hemodynamic monitoring alternatives. Although the correlation between inferior vena cava collapsibility index (IVC-CI) and central venous pressures (CVP) has been described previously, little information exists regarding the relationship between IVC-CI and pulmonary artery pressures (PAPs). The goal of this study is to bridge this important knowledge gap. We hypothesized that there would be an inverse correlation between IVC-CI and PAPs.

METHODS

A post hoc analysis of prospectively collected hemodynamic data was performed, examining correlations between IVC-CI and PAPs in a convenience sample of adult Surgical Intensive Care Unit patients. Concurrent measurements of IVC-CI and pulmonary arterial systolic (PAS), pulmonary arterial diastolic (PAD), and pulmonary arterial mean (PAM) pressures were performed. IVC-CI was calculated as ([IVCmax - IVCmin]/IVCmax) × 100%. Vena cava measurements were obtained by ultrasound-credentialed providers. For the purpose of correlative analysis, PAP measurements (PAS, PAD, and PAM) were grouped by terciles while the IVC-CI spectrum was divided into thirds (<33, 33-65, ≥66).

RESULTS

Data from 34 patients (12 women, 22 men, with median age of 59.5 years) were analyzed. Median Acute Physiologic Assessment and Chronic Health Evaluation II score was 9. A total of 76 measurement pairs were recorded, with 57% (43/76) obtained in mechanically ventilated patients. Correlations between IVC-CI and PAS (rs = -0.334), PAD (rs = -0.305), and PAM (rs = -0.329) were poor. Correlations were higher between CVP and PAS (R2 = 0.61), PAD (R2 = 0.68), and PAM (R2 = 0.70). High IVC-CI values (≥66%) consistently correlated with measurements in the lowest PAP ranges. Across all PAP groups (PAS, PAD, and PAM), there were no differences between the mean measurement values for the lower and middle IVC-CI ranges (0%-65%). However, all three groups had significantly lower mean measurement values for the ≥66% IVC-CI group.

CONCLUSIONS

Low PAS, PAD, and PAM measurements show a reasonable correlation with high IVC-CI (≥66%). These findings are consistent with previous descriptions of the relationship between IVC-CI and CVP. Additional research in this area is warranted to better describe the hemodynamic relationship between IVC-CI and PAPs, with the goal of further reduction in the reliance on the use of PACs.

Authors+Show Affiliations

Department of Research and Innovation, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA.Department of Anesthesiology, University of Toledo College of Medicine and Life Sciences, Toledo, USA.Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA.Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA.Department of Surgery, Division of Acute Care Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28149825

Citation

Stawicki, Stanislaw P., et al. "Correlations Between Pulmonary Artery Pressures and Inferior Vena Cava Collapsibility in Critically Ill Surgical Patients: an Exploratory Study." International Journal of Critical Illness and Injury Science, vol. 6, no. 4, 2016, pp. 194-199.
Stawicki SP, Papadimos TJ, Bahner DP, et al. Correlations between pulmonary artery pressures and inferior vena cava collapsibility in critically ill surgical patients: An exploratory study. International journal of critical illness and injury science. 2016;6(4):194-199.
Stawicki, S. P., Papadimos, T. J., Bahner, D. P., Evans, D. C., & Jones, C. (2016). Correlations between pulmonary artery pressures and inferior vena cava collapsibility in critically ill surgical patients: An exploratory study. International Journal of Critical Illness and Injury Science, 6(4), 194-199. https://doi.org/10.4103/2229-5151.195449
Stawicki SP, et al. Correlations Between Pulmonary Artery Pressures and Inferior Vena Cava Collapsibility in Critically Ill Surgical Patients: an Exploratory Study. International journal of critical illness and injury science. 2016 Oct-Dec;6(4):194-199. PubMed PMID: 28149825.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlations between pulmonary artery pressures and inferior vena cava collapsibility in critically ill surgical patients: An exploratory study. AU - Stawicki,Stanislaw P, AU - Papadimos,Thomas J, AU - Bahner,David P, AU - Evans,David C, AU - Jones,Christian, PY - 2017/2/3/entrez PY - 2017/2/6/pubmed PY - 2017/2/6/medline KW - Comparison study KW - correlations KW - inferior vena cava collapsibility index KW - pulmonary artery catheter KW - pulmonary artery pressures SP - 194 EP - 199 JF - International journal of critical illness and injury science VL - 6 IS - 4 N2 - INTRODUCTION: As pulmonary artery catheter (PAC) use declines, search continues for reliable and readily accessible minimally invasive hemodynamic monitoring alternatives. Although the correlation between inferior vena cava collapsibility index (IVC-CI) and central venous pressures (CVP) has been described previously, little information exists regarding the relationship between IVC-CI and pulmonary artery pressures (PAPs). The goal of this study is to bridge this important knowledge gap. We hypothesized that there would be an inverse correlation between IVC-CI and PAPs. METHODS: A post hoc analysis of prospectively collected hemodynamic data was performed, examining correlations between IVC-CI and PAPs in a convenience sample of adult Surgical Intensive Care Unit patients. Concurrent measurements of IVC-CI and pulmonary arterial systolic (PAS), pulmonary arterial diastolic (PAD), and pulmonary arterial mean (PAM) pressures were performed. IVC-CI was calculated as ([IVCmax - IVCmin]/IVCmax) × 100%. Vena cava measurements were obtained by ultrasound-credentialed providers. For the purpose of correlative analysis, PAP measurements (PAS, PAD, and PAM) were grouped by terciles while the IVC-CI spectrum was divided into thirds (<33, 33-65, ≥66). RESULTS: Data from 34 patients (12 women, 22 men, with median age of 59.5 years) were analyzed. Median Acute Physiologic Assessment and Chronic Health Evaluation II score was 9. A total of 76 measurement pairs were recorded, with 57% (43/76) obtained in mechanically ventilated patients. Correlations between IVC-CI and PAS (rs = -0.334), PAD (rs = -0.305), and PAM (rs = -0.329) were poor. Correlations were higher between CVP and PAS (R2 = 0.61), PAD (R2 = 0.68), and PAM (R2 = 0.70). High IVC-CI values (≥66%) consistently correlated with measurements in the lowest PAP ranges. Across all PAP groups (PAS, PAD, and PAM), there were no differences between the mean measurement values for the lower and middle IVC-CI ranges (0%-65%). However, all three groups had significantly lower mean measurement values for the ≥66% IVC-CI group. CONCLUSIONS: Low PAS, PAD, and PAM measurements show a reasonable correlation with high IVC-CI (≥66%). These findings are consistent with previous descriptions of the relationship between IVC-CI and CVP. Additional research in this area is warranted to better describe the hemodynamic relationship between IVC-CI and PAPs, with the goal of further reduction in the reliance on the use of PACs. SN - 2229-5151 UR - https://www.unboundmedicine.com/medline/citation/28149825/Correlations_between_pulmonary_artery_pressures_and_inferior_vena_cava_collapsibility_in_critically_ill_surgical_patients:_An_exploratory_study_ L2 - http://www.ijciis.org/article.asp?issn=2229-5151;year=2016;volume=6;issue=4;spage=194;epage=199;aulast=Stawicki DB - PRIME DP - Unbound Medicine ER -
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