Comparación entre valores de presión venosa central y presión venosa periférica en pacientes críticos

Objective: To analyze if venous peripheral pressure (PVP) measured by venous peripheral catheters can orientate us with sufficient reliability on the venous central pressure (PVC) • Material and method: market Study, observational, (June of 2006 - February of 2007) Patients were included by venous central and peripheral catheter. Central catheters were excluded without good morphology. PVC and PVP measured up simultaneously. There were registered values, morphologic quality, catheters, demography, pathology and treatment. Statistical analysis: percentages, averages, Student’s test and c2 • Results: 915 double determinations (100 patients). 70 was males. Middle ages 67,23±12. The most frequent pathology were: 25% ICC, 14% shock, 12% heart attack, 11% cerebral pathology, 11% surgeries, 8% digestive hemorrhage. Central catheters: 55,8% determinations were realized by catheter of termodilutión, 22,7% jugular; 16,39% subclavian, 1,7% by DRUM and 3,6% femoral. Peripheral catheters: 27,7% was G18, 62,2% G20, and 10,1% G22, 14, 16. Student’s test showed great correlation (p<0,0001), with average difference of 2,6 mmHg above the PVP. For 95 % the confidence interval is -2,87 -2,39. c2 showed major correlation with PVP´s good morphology (p <0,001) Student for this subgroup: p=0,0001, average difference 1,54. For 95 % (-1,68 to -1,40), standard error (SE) 0,28, vs the subgroup of muffled curves: p = 0,0001, average difference of 4,49, confidence interval of -5,28 to - 3,7, SE 0,4 and for the bad curves 5,24 (-6,16 to-4,31), SE 0,47 and p=0,0001. • Conclusions: Providing that there is registered morphology of correct VPP, the measurement of venous pressure for peripheral catheter can be the alternative to the VCP in patients without venous central catheter and with lower risks for the patient. VCP = VPP – 1,5 mmHg• Objetivo: analizar si la presión venosa periférica (PVP) medida por vías venosas periféricas cortas puede orientar con fiabilidad sobre la presión venosa central (PVC) • Material y método: Estudio prospectivo, observacional (Junio 2006-Junio 2008) Se incluyeron pacientes con catéter venoso central y periférico. Se excluyeron centrales de mal registro. Se midieron simultáneamente PVC y PVP. Se registraron valores, calidad morfológica, catéteres, demografía, patología y tratamiento. Análisis estadístico: porcentajes, medias, t. de Student y c2 . • Resultados: 915 determinaciones dobles (100 pacientes), 70% varones. Edad media 67,23±12. Patologías más frecuentes: 25% ICC, 25% shock, 12% IAM, 11% patología cerebral, 11% cirugía, 8% hemorragia digestiva. Catéteres centrales: 55,8% de las determinaciones por catéter de termodilución, 22,7% yugular; 16,39% subclavia; 1,7% catéter central de inserción periférica y 3,6% femoral. Catéteres periféricos: 27,7% G18; 62,2% G20 y 10,1% G22, 14 y 16. Student mostró gran correlación (p=0,0001), diferencia media 2,6 mmHg por encima en PVP. Error estándar (ES) 0,12. Para 95% intervalo de confianza -2,87 -2,39. c2 mostró correlación mayor para buena morfología de PVP (p