Central Venous Pressure Monitoring and Prognosis of High-risk Operating Patients
Study Details
Study Description
Brief Summary
While central venous pressure measurement is used to guide fluid management in high risk surgical patients during perioperative period, the relationship between the value of central venous pressure and organ dysfunction and prognosis of high-risk operating patients is unknow. In this study, we conducted a retrospective study of the relationship between the initial levels of CVP with organ dysfunction, the severity of illness, the length of ICU stay, and prognosis of critically ill patients.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Although less than 15% of high-risk patients (elderly or with limited cardiopulmonary reserves) undergo surgery, these patients account for 80% of hospital deaths. The requirements for hemodynamic monitoring to critical patients during perioperative period reach are of maximal importance, for two major reasons: (i) absolute or relative volume deficiency often occurs in postoperative patients due to preoperative fasting, intraoperative bleeding and non-dominant fluid loss caused by vasodilation and fluid redistribution caused by anesthesia; (ii) insufficient fluid replacement may lead to increased postoperative organ complications and poor wound healing. Adequate and goal-oriented hemodynamic monitoring combined with early and appropriate treatment can improve the prognosis of high-risk surgical patients.
Central venous pressure is a localized parameter of the superior vena cava or the right atrium and is closely related to the right ventricular end-diastolic pressure. With volume overload, CVP levels may be abnormally elevated. Maintaining central venous pressure as low as possible is conducive to the recovery of internal organs during haemodynamic treatment, especially for the kidney, intestine, and brain, etc. However, elevated central venous pressure (CVP) occurs frequently in critical care settings, including postoperative critical patients. In this study, we conducted a retrospective study of the relationship between the initial levels of CVP with organ dysfunction, the severity of illness, the length of ICU stay, and prognosis of critically ill patients.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Group A Patients with the initial central venous pressure(CVP1) <8 mm Hg |
Other: no intervention measures
Because this study was a retrospective study, no intervention measures were implemented for the patients enrolled.
|
| Group B Patients with 8≤CVP1≤12mm Hg |
Other: no intervention measures
Because this study was a retrospective study, no intervention measures were implemented for the patients enrolled.
|
| Group C Patients with CVP1>12 mm Hg |
Other: no intervention measures
Because this study was a retrospective study, no intervention measures were implemented for the patients enrolled.
|
Outcome Measures
Primary Outcome Measures
- Primary Outcome [28-day]
28-day mortality, length of stay in intensive care unit and hospitalization, surgical complications
Secondary Outcome Measures
- Secondary Outcome [1-day]
Comparison of perioperative fluid management in each group
Eligibility Criteria
Criteria
Inclusion Criteria:
- Age ≥18 years.⑵ All patients undergoing surgery and admitted to our intensive care unit (ICU) directly after surgery were enrolled into the respective study.⑶ They stayed in the ICU more than 48 hours with central venous pressure monitored for more than 48 hours.
Exclusion Criteria:
- Patients who were in pregnancy. ⑵Older than 80 years. ⑶Underwent cardiac surgery or had chronic kidney disease.
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Fujian Provincial Hospital
Investigators
- Principal Investigator: Jiafang Wu, M.D., Department of Critical Care Medicine, Fujian Provincial Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- K2018-09-006