CVP Measurement Through Sonography
A new report in the Journal of the American College of Cardiology suggests that there may be a non-invasive approach to measure central venous pressure (CVP) using controlled compression sonography. This is contrasted to the current technique using intravenous catheterization.
Compression sonography can monitor CVP through visualization of the cephalic vein. The pressure required to compress the vein is then determined; specifically, the collapse point pressure is an indirect measure of intravasal venous pressure. Notably, the approach is not intended for continuous monitoring of CVP.
The team from Switzerland evaluated the utility of this approach, completing a pilot project with ten healthy volunteers. Subjects underwent a range of induced hypertensive states. Noninvasive and invasive measures of CVP were strongly correlated.
The approach was then investigated among 50 patients in the intensive care setting. Seven patients were excluded because of inadequate venous access. Those patients had undergone multiple venipuncture procedures, common amongst those patients treated in this setting.
Two measurements were taken, using the forearm, to measure compression sonography, both at and below heart level. Findings indicated a negligible difference in the measure of CVP obtained with the invasive versus noninvasive approach.
Hemodynamic monitoring is crucial amongst critically ill patients. An alternative approach which is not invasive in nature would be welcome. Such an approach could minimize the likelihood of infections during monitoring. The method described may be well suited to the emergency room setting, which is not conducive to an invasive approach.
October 26, 2007 Related topics: Monitoring, Diagnostic, Emergency