Objective: The purpose of this study was to determine whether a relationship exists between
the inferior vena cava diameter (IVCD) or the superior vena cava diameter (SVCD) measured
at the point of entry into the right atrium using transesophageal echocardiography
(TEE) and the central venous pressure (CVP) under different experimental conditions.
Design: Prospective study.
Setting: University hospital, single institution.
Participants: Seventy patients undergoing elective cardiac surgery.
Interventions: CVP, IVCD, and SVCD were measured in a 2-dimensional, long-axis midesophageal bicaval
view at end-diastole with electrocardiographic synchronization. Data were recorded
during suspended ventilation, before and after leg elevation, and at different levels
of positive end-expiratory pressure (0, 5, and 10 cmH2O).
Measurements and Main Results: The relationship between IVCD and CVP had 2 portions: A first (CVP ≤11 mmHg) in which
the IVCD showed a strong correlation with the CVP (R = 0.801, p < 0.001; CVP = 2.009 + [0.312 * IVCD]) and a second (CVP >11 mmHg) in which the correlation
was poor (R = 0.272, p = 0.065). No correlation between SVCD and CVP was observed.
Conclusion: A strong correlation between TEE-derived IVCD measured at the point of entry into
the right atrium and CVP was observed in cardiac surgical patients when CVP was ≤11
mmHg.
Key Words
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Published online: December 30, 2006
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- Correlation of the Inferior Vena Cava Diameter With the Central Venous PressureJournal of Cardiothoracic and Vascular AnesthesiaVol. 22Issue 6
- PreviewWe read with great interest the article by Lorsomradee et al studying the inferior vena cava diameter (IVCD) and central venous pressure (CVP) correlation during cardiac surgery.1 We applaud their efforts in trying to find yet another means to determine preload in the operating room. We ourselves have been trying to elucidate the same question for the past 2 years and, in fact, presented a very similar study in 50 patients in the form of an abstract at the American Society of Anesthesiologists annual meeting in 2005.
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