Correlation of central venous pressure with venous blood gas analysis parameters; a diagnostic study

Sima Rahim-Taleghani; Alireza Fatemi; Mostafa Alavi Moghaddam; Majid Shojaee; Abdelrahman Ibrahim Abushouk; Mohammad Mehdi Forouzanfar; Alireza Baratloo

doi:10.1016/j.tjem.2016.09.006

Sima Rahim-Taleghani¹, Alireza Fatemi², Mostafa Alavi Moghaddam³, Majid Shojaee³, Abdelrahman Ibrahim Abushouk⁴, Mohammad Mehdi Forouzanfar¹, Alireza Baratloo⁵

¹Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
²Clinical Research Developmental Center, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
³Department of Emergency Medicine, Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
⁴Faculty of Medicine, Ain Shams University, Cairo, Egypt
⁵Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran

Keywords: Shock; Septic; Central venous pressure; Blood gas analysis; Emergency department; Emergency medicine

Abstract

Objective: This study was conducted to assess the correlation between central venous pressure (CVP) and venous blood gas (VBG) analysis parameters, to facilitate management of severe sepsis and septic shock in emergency department.

Material and methods: This diagnostic study was conducted from January 2014 until June 2015 in three major educational medical centers, Tehran, Iran. For patients selected with diagnosis of septic shock, peripheral blood sample was taken for testing the VBG parameters and the anion gap (AG) was calculated. All the mentioned parameters were measured again after infusion of 500 cc of normal saline 0.9% in about 1 h.

Results: Totally, 93 patients with septic shock were enrolled, 63 male and 30 female. The mean age was 72.53 ± 13.03 and the mean Shock Index (SI) before fluid therapy was 0.79 ± 0.30. AG and pH showed significant negative correlations with CVP, While HCO3 showed a significant positive correlation with CVP. These relations can be affected by the treatment modalities used in shock management such as fluid therapy, mechanical ventilation and vasopressor treatment.

Conclusion: It is likely that there is a significant statistical correlation between VBG parameters and AG with CVP, but further research is needed before implementation of the results of this study.