Projects

Background: Optimizing cardiovascular function to ensure adequate tissue oxygen
delivery is a key objective in the care of critically ill patients with burns. Hemodynamic
monitoring may be necessary to optimize resuscitation in serious burn patients with
reasonable safety. Invasive central venous pressure (CVP) monitoring has become the
corner stone of hemodynamic monitoring in patients with burns but is associated
with inherent risks and technical difficulties. Previous studies on perioperative patients
have shown that measurement of peripheral venous pressure (PVP) is a less invasive
and cost-effective procedure and can reliably predict CVP. Objective: The aim of the
present prospective clinical study was to determine whether a reliable association exists
between changes in CVP and PVP over a long period in patients admitted to the Burns
Intensive Care Unit (BICU). Subjects and Methods: The CVP and PVP were measured
simultaneously hourly in 30 burns patients in the BICU up to 10 consecutive hours. The
predictability of CVP by monitoring PVP was tested by applying the linear regression
formula and also using the Bland–Altman plots of repeated measures to evaluate the
agreement between CVP and PVP. Results: The regression formula revealed a reliable
and significant association between CVP and PVP. The overall mean difference between
CVP and PVP was 1.628 ± 0.84 mmHg (P < 0.001). The Bland–Altman diagram also
showed a perfect agreement between the two pressures throughout the 10 h period.
Conclusion: Peripheral venous pressure measured from a peripheral intravenous catheter
in burns patients is a reliable estimation of CVP, and its changes have good concordance
with CVP over a long period of time.
Keywords: Burns, central venous pressure, monitoring, peripheral venous pressure