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Central venous pressure and ultrasonographic measurement correlation and their associations with intradialytic adverse events in hospitalized patients: A prospective observational study.
J Crit Care. 2018 04; 44:168-174.JC

Abstract

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)mmHg and 6 (3-10)mmHg, respectively (P<0.01). In pre-dialysis, IVC collapsibility had the highest AUC (0.79, P<0.01) to predict CVP >8mmHg. In post-dialysis, IVC maximal diameter had the highest AUC (0.86, P<0.01) to predict CVP ≤4mmHg. 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.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States. Electronic address: sekiguchi.hiroshi@mayo.edu.Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States.Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States.Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, United States.Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States.Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, United States.Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States.Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, United States.

Pub Type(s)

Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29132056

Citation

Sekiguchi, Hiroshi, et al. "Central Venous Pressure and Ultrasonographic Measurement Correlation and Their Associations With Intradialytic Adverse Events in Hospitalized Patients: a Prospective Observational Study." Journal of Critical Care, vol. 44, 2018, pp. 168-174.
Sekiguchi H, Seaburg LA, Suzuki J, et al. Central venous pressure and ultrasonographic measurement correlation and their associations with intradialytic adverse events in hospitalized patients: A prospective observational study. J Crit Care. 2018;44:168-174.
Sekiguchi, H., Seaburg, L. A., Suzuki, J., Astorne, W. J., Patel, A. S., Keller, A. S., Gajic, O., & Kashani, K. B. (2018). Central venous pressure and ultrasonographic measurement correlation and their associations with intradialytic adverse events in hospitalized patients: A prospective observational study. Journal of Critical Care, 44, 168-174. https://doi.org/10.1016/j.jcrc.2017.10.039
Sekiguchi H, et al. Central Venous Pressure and Ultrasonographic Measurement Correlation and Their Associations With Intradialytic Adverse Events in Hospitalized Patients: a Prospective Observational Study. J Crit Care. 2018;44:168-174. PubMed PMID: 29132056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Central venous pressure and ultrasonographic measurement correlation and their associations with intradialytic adverse events in hospitalized patients: 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, Y1 - 2017/10/29/ PY - 2016/11/23/received PY - 2017/10/19/revised PY - 2017/10/28/accepted PY - 2017/11/14/pubmed PY - 2019/3/15/medline PY - 2017/11/14/entrez KW - Central venous pressure KW - Dry weight KW - Hemodialysis KW - Intradialytic adverse events KW - Ultrasonography SP - 168 EP - 174 JF - Journal of critical care JO - J Crit Care VL - 44 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)mmHg and 6 (3-10)mmHg, respectively (P<0.01). In pre-dialysis, IVC collapsibility had the highest AUC (0.79, P<0.01) to predict CVP >8mmHg. In post-dialysis, IVC maximal diameter had the highest AUC (0.86, P<0.01) to predict CVP ≤4mmHg. 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. SN - 1557-8615 UR - https://www.unboundmedicine.com/medline/citation/29132056/Central_venous_pressure_and_ultrasonographic_measurement_correlation_and_their_associations_with_intradialytic_adverse_events_in_hospitalized_patients:_A_prospective_observational_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-9441(16)30879-6 DB - PRIME DP - Unbound Medicine ER -