JR Munis et al. Anesth Analg 2001; 92:172-9.

Reviewed by: R. Prasad, MD

Conclusions:

• PVP trends CVP; very close correlation, independent of patient position.
• PVP approximates mean systemic pressure Pms (circulatory arrest pressure), which reflects volume status independent of cardiac function (Pms is ratio of blood volume to vascular compliance). As such, may be a useful guide to measuring/estimating relative blood volume

• Dr. Mueller has been doing this for years!
• Absolute numbers for PVP not important, although trend may be helpful.
• They only measured PVP during arrest in one pt ... hard to make firm conclusions about PVP as meausre of circ arrest pressure.

• 15 pts. Variety of neuro procedures, positions. GA, intubated, mechanically ventilated.
• All with RIJ or LIJ CVC.
• 18- or 20-gauge, 1.16in IV cath in dorsal hand or distal forearm veins
• PVP catheter site, and all transducers, maintained at midthorax height
• Anesthetic decisions made regardless of PVP readings.
• One pt studied under deep hypothermic circulatory arrest

Results:

• CVP showed more respiratory variation
• Variable PVP-CVP gradient, although gradient relatively stable throughout each case
• Tight dynamic correlation btwn CVP, PVP
• Overall correlation all data points, r=0.82. Even higher (0.923) where CVP very variable (ie, where std dev >2)
• Low incidence of mvmt of PVP and CVP in opposite directions, or either variable moving without a change in the other (13/921 = 1.4%)