Key result
SVC collapsibility index fails to reliably reflect CVP in cardiac surgical patients.
Why the study?
The relationship between superior vena cava diameter, collapsibility, and central venous pressure in cardiac surgical patients was unclear.
Do superior vena cava diameter and collapsibility measured by transoesophageal echocardiography correlate with central venous pressure in anesthetized cardiac surgical patients?
Observational (n=91)
Do superior vena cava diameter and collapsibility measured by transoesophageal echocardiography correlate with central venous pressure in anesthetized cardiac surgical patients?
Effect estimate: r=-0.21
p-value: p=0.049
SVC diameter and collapsibility measured by transoesophageal echocardiography do not reliably reflect central venous pressure in anesthetized cardiac surgical patients.
SVC parameters should not replace CVP monitoring in cardiac surgery; leaves open utility in other ventilated populations.
The aim of this study was to assess the relationship between superior vena cava (SVC) diameter, collapsibility and central venous pressure (CVP) in cardiac surgical patients. SVC maximum and minimum diameters, plus collapsibility with ventilation, were measured with transoesophageal echocardiography in the mid-oesophageal bicaval view with M-mode. Simultaneously, CVP was measured via the right atrial port of a pulmonary artery catheter. Measurements were possible in 91 out of 92 patients. The median CVP was 10 mmHg with a range of 2 to 19 mmHg. There was a weak, but statistically significant, correlation between CVP and SVC collapsibility index (r=-0.21, P=0.049). There was no statistically significant correlation between maximum SVC diameter and CVP. Maximum SVC diameter was statistically significantly correlated with weight (Pearson's r=0.28, P=0.008). There was no statistically significant correlation between CVP and age or body dimensions. Our findings indicate that SVC diameter and collapsibility are easily measured with transoesophageal echocardiography but do not reliably reflect CVP in anaesthetised cardiac surgical patients.
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Cowie et al. (2015) conducted an observational in Cardiac surgical patients (n=91). Superior vena cava diameter and collapsibility was evaluated on Correlation between central venous pressure (CVP) and SVC collapsibility index (r=-0.21, p=0.049). Superior vena cava collapsibility index had a weak correlation with central venous pressure (r=-0.21, P=0.049), indicating it does not reliably reflect CVP in cardiac surgical patients.