High Central Venous Pressure Associated with Mortality in Intensive Care Unit

Authors

  • Bastian Lubis Department of Anesthesiology, Faculty of Medicine, Universitas Sumatera Utara, Sumatera Utara, Indonesia https://orcid.org/0000-0002-1839-4146
  • Putri Amelia Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Sumatera Utara, Indonesia https://orcid.org/0000-0001-9941-2555
  • Vincent Viandy Department of Anesthesiology, Faculty of Medicine, Universitas Sumatera Utara, Sumatera Utara, Indonesia https://orcid.org/0000-0003-0461-4117

DOI:

https://doi.org/10.3889/oamjms.2022.8538

Keywords:

Central venous pressure, Mortality, Intensive care unit

Abstract

BACKGROUND: Central venous pressure (CVP) has been used as a measurement tool to assess hemodynamics, medication, and nutritional status in critically ill patients for decades. We frequently use the Acute Physiology and Chronic Health Evaluation or Sequential Organ Failure Assessment score to predict the mortality of intensive care unit (ICU) patients. Unfortunately, it requires a lot of time and procedures to measure these parameters. Moreover, not every single hospital can apply these scores. Since CVP is widely used in ICU, we can use the value of CVP to predict mortality.

AIM: The aim of this study was to find the correlation between CVP and mortality rate.

METHODS: This cross-sectional study was conducted in ICU of Haji Adam Malik General Hospital, Medan, in 2017. Basic demographic data, CVP measurements and mortality were recorded among all ICU patients. Patients with CVP >12 mmHg were considered high. The association between CVP and mortality was analyzed.

RESULTS: One hundred patients were admitted during the study period with mortality rate of 38%. The most common cause of ICU admission was postoperative neurosurgical patients (28%). We found correlation between high CVP (>12 mmHg) and mortality among ICU patients (odds ratio: 3.372; 95% confidence interval: 1.349–8.428; p = 0.008)

CONCLUSION: CVP level >12 mmHg associated with higher mortality rate in ICU patients.

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References

Jones AE, Trzeciak S, Kline JA. The sequential organ failure assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Critl Care Med. 2009;37(5):1649. https://doi.org/10.1097/CCM.0b013e31819def97 PMid:19325482 DOI: https://doi.org/10.1097/CCM.0b013e31819def97

Ozaydin MG, Guneysel O, Saridogan F, Ozaydin V. Are scoring systems sufficient for predicting mortality due to sepsis in the emergency department? Turk J Emerg Med. 2017;17(1):25-8. https://doi.org/10.1016/j.tjem.2016.09.004 PMid:28345070 DOI: https://doi.org/10.1016/j.tjem.2016.09.004

Gumbsch T, Borgwardt K. Ethnicity-based bias in clinical severity scores. Lancet Digit Health. 2021;3(4):209-10. https://doi.org/10.1016/s2589-7500(21)00044-3 PMid:33766286 DOI: https://doi.org/10.1016/S2589-7500(21)00044-3

Ortoleva JP, Cordes CL, Salehi P, Shapeton AD. Predictive scoring: Should it tell us the odds? J Cardiothorac Vascu Anesth. 2021;35(12):3708-10. https://doi.org/10.1053/j.jvca.2021.09.020 PMid:34627710 DOI: https://doi.org/10.1053/j.jvca.2021.09.020

Aminiahidashti H, Bozorgi F, Montazer SH, Baboli M, Firouzian A. Comparison of APACHE II and SAPS II scoring systems in prediction of critically ill patients’ outcome. Emerg(Tehran). 2017;5(1):4. https://doi.org/10.26226/Morressier.57108e31d462b80290b4ab73 PMid:28286811 DOI: https://doi.org/10.26226/morressier.57108e31d462b80290b4ab73

Minne L, Abu-Hanna A, De Jonge E. Evaluation of SOFA-based models for predicting mortality in the ICU: A systematic review. Crit Care. 2008;12(6):161. https://doi.org/10.1186/cc7160 PMid:19091120 DOI: https://doi.org/10.1186/cc7160

Saleh A, Ahmed M, Sultan I, Abdel-Lateif A. Comparison of the mortality prediction of different ICU scoring systems (APACHE II and III, SAPS II, and SOFA) in a single-center ICU subpopulation with acute respiratory distress syndrome. Egypt J Chest Dis Tuberc. 2015;64(4):843-8. https://doi.org/10.1016/j.ejcdt.2015.05.012 DOI: https://doi.org/10.1016/j.ejcdt.2015.05.012

Boyd JH, Forbes J, Nakada TA, Walley KR, Russell JA. Fluid resuscitation in septic shock: A positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med. 2011;39(2):259-65. https://doi.org/10.1097/ccm.0b013e3181feeb15 PMid:20975548 DOI: https://doi.org/10.1097/CCM.0b013e3181feeb15

Li Dk, Wang XT, Liu DW. Association between elevated central venous pressure and outcomes in critically ill patients. Ann Intensive Care. 2017;7(1):83. https://doi.org/10.1186/s13613-017-0306-1 PMid:28795349 DOI: https://doi.org/10.1186/s13613-017-0306-1

Marik PE, Baram M, Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest. 2008;134(1):172-8. https://doi.org/10.1378/chest.07-2331 PMid:18628220 DOI: https://doi.org/10.1378/chest.07-2331

Chen KP, Cavender S, Lee J, Feng M, Mark RG, Celi LA, et al. Peripheral edema, central venous pressure, and risk of AKI in critical illness. Clin J Am Soc Nephrol. 2016;11(4):602-8. https://doi.org/10.2215/cjn.08080715 PMid:26787777 DOI: https://doi.org/10.2215/CJN.08080715

Mullens W, Abrahams Z, Francis GS, Sokos G, Taylor DO, Starling RC, et al. Importance of venous congestion for worsening of renal function in advanced decompensated heart failure. J Am Coll Cardiol. 2009;53(7):589-96. https://doi.org/10.1016/j.jacc.2008.05.068 PMid:19215833 DOI: https://doi.org/10.1016/j.jacc.2008.05.068

Choi SJ, Ha EJ, Jhang WK, Park SJ. Elevated central venous pressure is associated with increased mortality in pediatric septic shock patients. BMC Pediatr. 2018;18(1):58. https://doi.org/10.1186/s12887-018-1059-1 DOI: https://doi.org/10.1186/s12887-018-1059-1

Shah P, Louis MA. Physiology, Central Venous Pressure. Treasure Island, FL: StatPearls Publishing; 2020.

Whitehead EH, Thayer KL, Burkhoff D, Uriel N, Ohman EM, O’Neill W, et al. Central venous pressure and clinical outcomes during left-sided mechanical support for acute myocardial infarction and cardiogenic shock. Front Cardiovasc Med. 2020;7:155. https://doi.org/10.3389/fcvm.2020.00155 PMid:33005634 DOI: https://doi.org/10.3389/fcvm.2020.00155

Chung KP, Chang HT, Huang YT, Liao CH, Ho CC, Jerng JS, et al. Central venous oxygen saturation under non-protocolized resuscitation is not related to survival in severe sepsis or septic shock. Shock. 2012;38(6):584-91. https://doi.org/10.1097/shk.0b013e318274c674 PMid:23143064 DOI: https://doi.org/10.1097/SHK.0b013e318274c674

Lobo SM, Rezende E, Knibel MF, Silva NB, Páramo JA, Nácul FE, et al. Early determinants of death due to multiple organ failure after noncardiac surgery in high-risk patients. Anesth Analg. 2011;112(4):877-83. https://doi.org/10.1213/ane.0b013e3181e2bf8e PMid:20530615 DOI: https://doi.org/10.1213/ANE.0b013e3181e2bf8e

Chen CY, Zhou Y, Wang P, Qi EY, Gu WJ. Elevated central venous pressure is associated with increased mortality and acute kidney injury in critically ill patients: A meta-analysis. Crit Care. 2020;24(1):80. https://doi.org/10.1186/s13054-020-2770-5 PMid:32138764 DOI: https://doi.org/10.1186/s13054-020-2770-5

Berlin DA, Bakker J. Starling curves and central venous pressure. Crit Care. 2015;19(1):55. https://doi.org/10.1186/s13054-015-0776-1 PMid:25880040 DOI: https://doi.org/10.1186/s13054-015-0776-1

Malbrain ML, Marik PE, Witters I, Cordemans C, Kirkpatrick AW, Roberts DJ, et al. Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients: A systematic review with suggestions for clinical practice. Anaesthesiol Intensive Ther. 2014;46(5):361-80. https://doi.org/10.5603/ait.2014.0060 PMid:25432556 DOI: https://doi.org/10.5603/AIT.2014.0060

Simmons J, Ventetuolo CE. Cardiopulmonary monitoring of shock. Curr Opin Critl Care. 2017;23(3):223-31. https://doi.org/10.1097/mcc.0000000000000407 PMid:28398907 DOI: https://doi.org/10.1097/MCC.0000000000000407

Vahdatpour C, Collins D, Goldberg S. Cardiogenic shock. J Am Heart Assoc. 2019;8(8):011991. https://doi.org/10.1161/JAHA.119.011991 PMid:30947630 DOI: https://doi.org/10.1161/JAHA.119.011991

Pilat J, Dabrowski W, Biernacka J, Bicki J, Rudzki S. Changes in intra-abdominal, iliac venous and central venous pressures in patients undergoing abdominal surgery due to large tumors of the colon: A pilot study. Acta Clin Croat. 2010;49(4):381-8. PMid:21830448

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Published

2022-03-20

How to Cite

1.
Lubis B, Amelia P, Viandy V. High Central Venous Pressure Associated with Mortality in Intensive Care Unit. Open Access Maced J Med Sci [Internet]. 2022 Mar. 20 [cited 2024 Apr. 26];10(B):1052-5. Available from: https://oamjms.eu/index.php/mjms/article/view/8538

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