Friday April 13, 2007
CVP (central venous pressure) via femoral central line

There are very few studies available correlating accuracy of CVP (central venous pressure) via femoral line. One study published in lancet a decade ago provides clue that as near the catheter tip to the right atrium, better would be the correlation 1. Another small study later showed reliable accuracy from common iliac venous line 2.

This year at 27th International Symposium on Intensive Care and Emergency Medicine held at Brussels, Belgium (27–30 March 2007), a study of 41 patients was presented, with each one of those patients had a central venous catheter (CVC) in two different locations, one placed in the internal jugular or subclavian veins, and a second in a femoral vein. Simultaneous measurements of CVP were undertaken by two different operators, with a pressure transducer zero referenced at the mid-chest. 4 patients with an intra-abdominal pressure (IAP) more than 15 mmHg were excluded.

The mean CVP measured with jugular/subclavian access was 11.3 ± 4.5 mmHg, and in the femoral access was 11.8 ± 4.4 mmHg ( P less than 0.007).

Study concluded that CVP can be accurately measured in a femoral vein, using standard CVC, in patients with normal Intra-abdominal pressure 3.


Editors' comment: Standard is CVP measurement via central line placed in thoracic region. CVP via PICC line or femoral central line should be obtained and used only when thoracic access is not feasible.


Related previous pearls: CVP via PICC , CVP via biggest port on venous catheter ! , PICC or CVC ? , Power PICC



References: click to get abstract / article

1. Comparison of intrathoracic and intra-abdominal measurements of central venous pressure - Lancet. 1996 Apr 27;347(9009):1155-7.
2. Central venous pressure from common iliac vein reflects right atrial pressure - CAN J ANAESTH 1998 / 45: 8 / pp 798-801
3. Central venous pressure in a femoral access: a true evaluation ? Critical Care 2007, 11(Suppl 2):P277