Noninvasive Central Venous Pressure Measurement by Controlled Compression Sonography at the Forearm
Christoph Thalhammer, MD*,*,
Markus Aschwanden, MD*,
Angela Odermatt*,
Ulrich A. Baumann, MD ,
Stephan Imfeld, MD*,
Deniz Bilecen, MD, PhD ,
Stephan C. Marsch, MD, PhD and
Kurt A. Jaeger, MD*
* Department of Vascular Medicine
Department of Diagnostic Radiology
Medical Intensive Care Unit, University Hospital, Basel, Switzerland
Regional Hospital Center, Muensingen, Switzerland
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Figure 1 Noninvasive Pressure Measurement
(A) Pressure manometer connected to ultrasound transducer: (1) translucent silicone membrane, (2) ultrasound transducer, (3) flexible pressure tubing, (4) pressure meter. (B) Cross-sectional sonography: cephalic vein before and after compression.
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Figure 2 Artificial Venous Hypertension and Interobserver Agreement
(A) Venous hypertension. Mean invasive peripheral venous pressure (PVPi) without cuff compression was 19.6 ± 4.7 cm H2O, followed by a linear increase in PVPi above a cuff pressure of 15 mm Hg. Maximal PVPi was 67.8 ± 6.9 cm H2O. (B) Interobserver agreement: intraclass correlation coefficient was 0.988. PVPn = noninvasive peripheral venous pressure.
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Figure 3 PVPi and PVPn in Healthy Subjects
(A) Linear regression: positive correlation between PVPi and PVPn. (B) Bland-Altman plot: PVPi and PVPn plotted against their mean. Abbreviations as in Figure 2.
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Figure 4 Below Heart Level Measurements in ICU Patients
(A) Linear regression: positive correlation between central venous pressure (CVP) and PVPn. (B) Bland-Altman plot: CVP and PVPn plotted against their mean. ICU = intensive care unit; other abbreviations as in Figure 2.
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Figure 5 Heart Level Measurements in ICU Patients
(A) Linear regression: positive correlation between CVP and PVPn. (B) Bland-Altman plot: CVP and PVPn plotted against their mean. Abbreviations as in Figures 2 and 4.
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