scholarly journals Central venous pressure measurement is associated with improved outcomes in septic patients: an analysis of the MIMIC-III database

2020 ◽  
Author(s):  
Hui Chen ◽  
Zhu Zhu ◽  
Chenyan Zhao ◽  
Yanxia Guo ◽  
Dongyu Chen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Central Venous Pressure ◽  
Medical Information ◽  
Venous Pressure ◽  
Serum Lactate ◽  
Mediating Effect ◽  
Mediation Effect ◽  
Clinical Tool ◽  
Central Venous ◽  
Mimic Iii

Abstract Purpose: Measurement of central venous pressure (CVP) can be a useful clinical tool. However, the formal utility of CVP measurement in preventing mortality in septic patients has never been proven.Methods: The Medical Information Mart for Intensive Care III (MIMIC-III) database was searched to identify septic patients with and without CVP measurements. The primary outcome was 28-day mortality. Multivariate regression was used to elucidate the relationship between CVP measurement and 28-day mortality, and propensity score matching (PSM) and an inverse probability of treatment weighing (IPTW) were employed to validate our findings. Results: A total of 10275 patients were included in our study, of which 4516 patients (44%) underwent CVP measurement within 24 h of intensive care unit (ICU) admission. The risk of 28-day mortality was reduced in the CVP group (OR 0.60 (95% CI 0.51-0.70; p<0.001)). Patients in the CVP group received more fluid on day 1, and had a shorter duration of mechanical ventilation and vasopressor use, and the reduction in serum lactate was greater than that in the no CVP group. The mediating effect of serum lactate reduction was significant for the whole cohort (p=0.04 for the average causal mediation effect (ACME)) and patients in the CVP group with an initial CVP level below 8 mmHg (p=0.04 for the ACME).Conclusion: CVP measurement was associated with decreased risk-adjusted 28-day mortality among patients with sepsis and was proportionally mediated through serum lactate reduction.

scholarly journals Central venous pressure measurement is associated with improved outcomes in septic patients: an analysis of the MIMIC-III database

2020 ◽  
Author(s):  
Hui Chen ◽  
Zhu Zhu ◽  
Chenyan Zhao ◽  
Yanxia Guo ◽  
Dongyu Chen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Central Venous Pressure ◽  
Medical Information ◽  
Venous Pressure ◽  
Serum Lactate ◽  
Mediating Effect ◽  
Mediation Effect ◽  
Clinical Tool ◽  
Central Venous ◽  
Mimic Iii

Abstract Purpose: Measurement of central venous pressure (CVP) can be a useful clinical tool. However, the formal utility of CVP measurement in preventing mortality in septic patients has never been proven. Methods: The Medical Information Mart for Intensive Care III (MIMIC-III) database was searched to identify septic patients with and without CVP measurements. The primary outcome was 28-day mortality. Multivariate regression was used to elucidate the relationship between CVP measurement and 28-day mortality, and propensity score matching (PSM) and an inverse probability of treatment weighing (IPTW) were employed to validate our findings. Results: A total of 10275 patients were included in our study, of which 4516 patients (44%) underwent CVP measurement within 24 h of intensive care unit (ICU) admission. The risk of 28-day mortality was reduced in the CVP group (OR 0.60 (95% CI 0.51-0.70; p<0.001)). Patients in the CVP group received more fluid on day 1, and had a shorter duration of mechanical ventilation and vasopressor use, and the reduction in serum lactate was greater than that in the no CVP group. The mediating effect of serum lactate reduction was significant for the whole cohort (p=0.04 for the average causal mediation effect (ACME)) and patients in the CVP group with an initial CVP level below 8 mmHg (p=0.04 for the ACME). Conclusion: CVP measurement was associated with decreased risk-adjusted 28-day mortality among patients with sepsis and was proportionally mediated through serum lactate reduction.

scholarly journals Measurement of central venous pressure is associated with better outcomes in septic patients: a retrospective observational study

2020 ◽  
Author(s):  
Hui Chen ◽  
Zhu Zhu ◽  
Chenyan Zhao ◽  
Yanxia Guo ◽  
Dongyu Chen ◽  
...  
Keyword(s):  
Central Venous Pressure ◽  
Medical Information ◽  
Venous Pressure ◽  
Serum Lactate ◽  
Mediation Effect ◽  
Central Venous ◽  
Causal Mediation ◽  
Causal Mediation Analysis ◽  
Vasopressor Use ◽  
The Relationship

Abstract Purpose: With the proper insights, measurement of central venous pressure (CVP) can be a useful clinical aid. However, the formal utility of CVP measurement on mortality in septic patients has never been proved.Methods: The Medical Information Mart for Intensive Care III (MIMIC-III) was applied to identify septic patients who had and did not have CVP measured. The primary outcome was 28-day mortality. The statistical approaches including multivariate regression, propensity score matching (PSM) and an inverse probability of treatment weighing (IPTW) and causal mediation analysis (CMA) were utilized to elucidate the relationship between CVP measurement and 28-day mortality.Results: A total of 10275 patients were included in our study, of which 4516 patients (44%) had CVP measured within 24 h after ICU admission. A significant beneficial effect of CVP measurement in terms of 28-day mortality was observed (OR 0.60 (95% CI 0.51–0.70; p<0.001)). Patients in CVP group received more fluid on day 1, had a shorter duration of mechanical ventilation and vasopressor use, and the reduction of serum lactate was higher than that in the no CVP group. The mediation effect of serum lactate reduction was significant for the whole cohort (p=0.04 for average causal mediation effect (ACME)) and patients in the CVP group with an initial CVP level below 8mmHg (p=0.04 for ACME).Conclusion: CVP measurement is associated with a lower risk-adjusted 28-day mortality among patients with sepsis, which is proportionally mediated through serum lactate reduction.

Evaluación del conocimiento del enfermero sobre la importancia del monitoreo de la presión venosa central en pacientes críticos

2011 ◽  
Vol 5 (9) ◽  
pp. 2091
Author(s):  
Rayssa Nogueira Duarte ◽  
Sarah Maria de Sousa Feitoza ◽  
Elizabeth Mesquita Melo ◽  
Islene Victor Barbosa ◽  
Rita Mônica Borges Studart ◽  
...  
Keyword(s):  
Intensive Care ◽  
Central Venous Pressure ◽  
Normal Values ◽  
Venous Pressure ◽  
Venous Catheter ◽  
Central Venous ◽  
X Ray ◽  
Hemodynamic Impairment ◽  
Terapia Intensiva ◽  
Definition Of

RESUMENObjective: identificar el conocimiento del enfermero sobre el monitoreo de la presión venosa central (PVC) en columna de agua en pacientes críticos. Método: estudio exploratorio descriptivo, cuantitativo, realizado en dos unidades de cuidados intensivos con 24 enfermeros. Datos recolectados de enero a abril de 2010, por medio de un cuestionario, agrupados en frecuencias absolutas y relativas, y expuestos en figuras y tablas. El proyecto fue encaminado al Comité de Ética en Investigación del Hospital São José, aprobado con el protocolo 055/2009, CAAE 0056.0.042.000-9. Resultados: mayoría de sexo femenino, con media de edad de 38,2 y 13,4 años de formación; 45,8% conocían la definición de PVC y 54,16 relataron correctamente sus valores normales. Aunque 62,5% no citó dificultades con la PVC, se observaron dudas sobre posición del catéter venoso central, chequeo por rayo-x, e identificación del eje flebostático del paciente. Conclusiones: se identificó falta de conocimiento sobre la importancia y objetivos de la PVC para seguimiento de la hemodinámica del paciente grave, siendo esencial una educación en servicio sobre la temática. Descriptores: atención de enfermería; presión venosa central; unidad de cuidados intensivos.ABSTRACTObjective: to evaluate the knowledge of nurse about of the monitoring the central venous pressure (CVP) in the water column in critically ill patients. Method: exploratory quantitative study, conducted in two intensive care units with 24 nurses. Data were collected from January to April 2010, after the Research Ethics Committee of the Hospital São José approved the project (Protocol protocolo 055/2009, CAAE 0056.0.042.000-9), with a questionnaire, grouped in absolute and relative frequencies and displayed in figures and tables. Results: the sample were mainly female, mean age of 38.2 and 13.4 years after graduation, 45.8% knew the definition of PVC and 54.16% correctly reported their normal values. While 62.5% have not mentioned difficulties related to PVC, there was doubt about the position of central venous catheter by x-ray check and identification phlebostatic axis of the patient. Conclusion: we identified a lack of knowledge related to the importance and goals of CVP monitoring the patient's hemodynamic impairment, being essentially an in-service education on the topic. Descriptors: nursing care; central venous pressure; intensive care unit.RESUMOObjetivo: avaliar o conhecimento do enfermeiro sobre a monitorização da pressão venosa central (PVC) em coluna de água em pacientes críticos. Método: estudo exploratório descritivo, quantitativo, realizado em duas unidades de terapia intensiva, com 24 enfermeiros. Os dados foram coletados de janeiro a abril de 2010, com um questionário, agrupados em freqüências absoluta e relativa, sendo expostos em figuras e tabela. O projeto foi encaminhado ao Comitê de Ética em Pesquisa do Hospital São José de Doenças Infecciosas, aprovado com protocolo 055/2009, CAAE 0056.0.042.000-9. Resultados: a maioria era do sexo feminino, com média de idade de 38,2 e 13,4 anos de formado; 45,8% conheciam a definição de PVC e 54,16% relataram corretamente seus valores normais. Embora 62,5% não tenham citado dificuldades relativas à PVC, observou-se dúvidas quanto a posição do cateter venoso central, checagem pelo raio-x e identificação do eixo flebostático do paciente. Conclusões: identificou-se déficit de conhecimento relacionado à importância e objetivos da PVC no acompanhamento da hemodinâmica do paciente grave, sendo essencial uma educação em serviço sobre a temática. Descritores: assistência de enfermagem; pressão venosa central; unidade de terapia intensiva.

Influence of infusion flow rates on central venous pressure measurements through multi-lumen central venous catheters in intensive care

2006 ◽  
Vol 32 (3) ◽  
pp. 460-463 ◽  
Author(s):  
Karim Lakhal ◽  
Martine Ferrandière ◽  
François Lagarrigue ◽  
Colette Mercier ◽  
Jacques Fusciardi ◽  
...  
Keyword(s):  
Intensive Care ◽  
Central Venous Pressure ◽  
Venous Pressure ◽  
Central Venous Catheters ◽  
Pressure Measurements ◽  
Central Venous ◽  
Flow Rates

Intensive Care for Patients with Subarachnoid Haemorrhage

2002 ◽  
Vol 15 (5) ◽  
pp. 619-623
Author(s):  
M. Berardino ◽  
P.F. Sciacca
Keyword(s):  
Intensive Care ◽  
Subarachnoid Haemorrhage ◽  
Central Venous Pressure ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Venous Pressure ◽  
Intensive Care Treatment ◽  
Central Venous ◽  
Cerebral Monitoring

The intensive care treatment in patients with subarachnoid haemorrhage (SAH) is aimed at maintenance of adequate cerebral perfusion and oxygenation. SAH is charged in 40% of cases with at least one life-threatening event and 20 to 30% of deaths are related to extracerebral complications. So the main task in Neurointensive Care is to keep the physiological parameters under control. That is why we need accurate monitoring. Currently used systemic and cerebral monitoring is thus presented. Even basic cardiovascular monitoring (ECG, blood pressure, pulse oxymetry, central venous pressure, urine output) need a great workload in managing the quality of signals and raw data. SAH is often associated with cardiovascular impairment; haemodynamic monitoring is then necessary to graduate hynotropic (stroke volume, cardiac index, systemic and pulmonary resistances) and volemic support (central venous pressure, wedge pressure): a Swan-Ganz catheter is then indicated. Then ventilation is considered: non only a “cerebral” oriented ventilation but a strategy aimed at pulmonary protection too. The ultimate result of ventilation is still adequate oxygenation and acid-base balance that are to be verified. Cerebral monitoring is then resumed starting from cerebral perfusion pressure. The O2 delivery is monitored by a global estimation like jugular venous oxygen saturation, that has a low sensitivity in SAH patients, and by tissue O2 tension which measure O2 delivered near the injured area. Lastly, Transcranial Doppler Monitoring is presented with its limits and indications. Three clinical examples are presented on a multimodal approach in TCD, PtO2 and cerebral perfusion pressure monitoring.

scholarly journals Central venous pressure correlates with inferior vena cava collapsibility index in patients treated in intensive care unit

2017 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
EmkelPerangin Angin ◽  
Made Wiryana ◽  
IKetut Sinardja ◽  
IWayan Aryabiantara ◽  
TjokordaGdeAgung Senapathi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Inferior Vena Cava ◽  
Central Venous Pressure ◽  
Inferior Vena ◽  
Venous Pressure ◽  
Vena Cava ◽  
Central Venous ◽  
Collapsibility Index
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