Xiaoting Wang1, Huan Chen1, Dawei Liu2, Qing Zhang1, Longxiang Su1. 1. Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, China. 2. Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, China. Electronic address: pumchicuky@163.com.
Abstract
OBJECTIVE: To investigate the effect of central venous pressure on the organ dysfunction and prognosis of critically ill patients. METHODS: We conducted a retrospective observational cohort study of 488 ICU patients with central venous pressure and its derived parameters in a half-year period in one single ICU centre to compare the length of ICU stay, critical illness scores (SOFA and APACHE II), serum creatinine and lactate levels. RESULTS: The initial, peak and mean CVP levels of critically ill patients and length of ICU stay, peak lactate levels and SOFA scores were significantly correlated. While the peak CVP and peak creatinine levels were significantly correlated, the correlation of initial and mean CVP levels with peak creatinine was not significant. Subgroup analysis showed that in the patients with a peak CVP value above 12mmHg, the length of stay was significantly prolonged, organ function was significantly worse, and the SOFA score was significantly higher. ROC analysis showed peak levels of CVP above 11.5mmHg had the greatest ability to predict mortality of critically ill patients. CONCLUSION: Exposure to higher levels of central venous pressure in critically ill patients is associated with a poorer prognosis and worse organ function. Therefore, central venous pressure should be kept as low as possible during hemodynamic therapy in critically ill patients.
OBJECTIVE: To investigate the effect of central venous pressure on the organ dysfunction and prognosis of critically illpatients. METHODS: We conducted a retrospective observational cohort study of 488 ICU patients with central venous pressure and its derived parameters in a half-year period in one single ICU centre to compare the length of ICU stay, critical illness scores (SOFA and APACHE II), serum creatinine and lactate levels. RESULTS: The initial, peak and mean CVP levels of critically illpatients and length of ICU stay, peak lactate levels and SOFA scores were significantly correlated. While the peak CVP and peak creatinine levels were significantly correlated, the correlation of initial and mean CVP levels with peak creatinine was not significant. Subgroup analysis showed that in the patients with a peak CVP value above 12mmHg, the length of stay was significantly prolonged, organ function was significantly worse, and the SOFA score was significantly higher. ROC analysis showed peak levels of CVP above 11.5mmHg had the greatest ability to predict mortality of critically illpatients. CONCLUSION: Exposure to higher levels of central venous pressure in critically illpatients is associated with a poorer prognosis and worse organ function. Therefore, central venous pressure should be kept as low as possible during hemodynamic therapy in critically illpatients.