کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2610136 1134582 2014 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Alternative Methods to Central Venous Pressure for Assessing Volume Status in Critically Ill Patients
ترجمه فارسی عنوان
روش های جایگزین برای فشار خون ورید مرکزی برای ارزیابی وضعیت دوره در بیماران مبتلا به بحرانی
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پرستاری و مشاغل بهداشتی امداد اورژانس
چکیده انگلیسی

IntroductionEarly goal-directed therapy increases survival in persons with sepsis but requires placement of a central line. We evaluate alternative methods to measuring central venous pressure (CVP) to assess volume status, including peripheral venous pressure (PVP) and stroke volume variation (SVV), which may facilitate nurse-driven resuscitation protocols.MethodsPatients were enrolled in the emergency department or ICU of an academic medical center. Measurements of CVP, PVP, SVV, shoulder and elbow position, and dichotomous variables Awake, Movement, and Vented were measured and recorded 7 times during a 1-hour period. Regression analysis was used to predict CVP from PVP and/or SVV, shoulder/elbow position, and dichotomous variables.ResultsTwenty patients were enrolled, of which 20 had PVP measurements and 11 also had SVV measurements. Multiple regression analysis demonstrated significant predictive relationships for CVP using PVP (CVP = 6.7701 + 0.2312 × PVP – 0.1288 × Shoulder + 12.127 × Movement – 4.4805 × Neck line), SVV (CVP = 14.578 – 0.3951 × SVV + 18.113 × Movement), and SVV and PVP (CVP = 4.2997 – 1.1675 × SVV + 0.3866 × PVP + 18.246 × Awake + 0.1467 × Shoulder = 0.4525 × Elbow + 15.472 × Foot line + 10.202 × Arm line).DiscussionPVP and SVV are moderately good predictors of CVP. Combining PVP and SVV and adding variables related to body position, movement, ventilation, and sleep/wake state further improves the predictive value of the model. The models illustrate the importance of standardizing patient position, minimizing movement, and placing intravenous lines proximally in the upper extremity or neck.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Emergency Nursing - Volume 40, Issue 2, March 2014, Pages 115–123
نویسندگان
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