Association between elevated central venous pressure and outcomes in critically ill patients

Association between elevated central venous pressure and outcomes in critically ill patients Background: Some prior studies have shown that elevated mean central venous pressure in certain patient popula‑ tions and disease processes may lead to poor prognosis. However, these studies failed to generalize the concept of elevated central venous pressure (ECVP) load to all patients in critical care settings because of the limited cases and exclusive cohorts. The aim of the study was to investigate the association between elevated central venous pressure and outcomes in critical care. Methods: We performed a retrospective analysis on a single‑ center public database (MIMIC) of more than 9000 patients and more than 500,000 records of central venous pressure measurement. We evaluated the association between mean central venous pressure level and 28‑ day mortality after intensive care unit admission. The secondary outcomes were duration of mechanical ventilation, vasoactive drug use, laboratory results related to organ dysfunc‑ tion and length of intensive care unit hospitalization. Accordingly, we proposed the concept of EC VP (the time sum of CVP above 10 mmHg) and investigated its association with outcome. Results: There were 1645 deaths at 28 days after admission. Compared with the lowest quartile of mean central venous pressure [mean (SD) 7.4 (1.9) mmHg], the highest quartile [17.4 (4.1) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Intensive Care Springer Journals

Association between elevated central venous pressure and outcomes in critically ill patients

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Publisher
Springer International Publishing
Copyright
Copyright © 2017 by The Author(s)
Subject
Medicine & Public Health; Intensive / Critical Care Medicine; Emergency Medicine; Anesthesiology
eISSN
2110-5820
D.O.I.
10.1186/s13613-017-0306-1
Publisher site
See Article on Publisher Site

Abstract

Background: Some prior studies have shown that elevated mean central venous pressure in certain patient popula‑ tions and disease processes may lead to poor prognosis. However, these studies failed to generalize the concept of elevated central venous pressure (ECVP) load to all patients in critical care settings because of the limited cases and exclusive cohorts. The aim of the study was to investigate the association between elevated central venous pressure and outcomes in critical care. Methods: We performed a retrospective analysis on a single‑ center public database (MIMIC) of more than 9000 patients and more than 500,000 records of central venous pressure measurement. We evaluated the association between mean central venous pressure level and 28‑ day mortality after intensive care unit admission. The secondary outcomes were duration of mechanical ventilation, vasoactive drug use, laboratory results related to organ dysfunc‑ tion and length of intensive care unit hospitalization. Accordingly, we proposed the concept of EC VP (the time sum of CVP above 10 mmHg) and investigated its association with outcome. Results: There were 1645 deaths at 28 days after admission. Compared with the lowest quartile of mean central venous pressure [mean (SD) 7.4 (1.9) mmHg], the highest quartile [17.4 (4.1)

Journal

Annals of Intensive CareSpringer Journals

Published: Aug 9, 2017

References

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