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https://hdl.handle.net/2440/8240
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Type: | Journal article |
Title: | Lack of agreement between central venous pressure and pulmonary capillary wedge pressure in preeclampsia |
Author: | Bolte, A. Dekker, G. van Eyck, J. van Schijndel, R. van Geijn, H. |
Citation: | Hypertension in Pregnancy, 2000; 19(3):261-271 |
Publisher: | Marcel Dekker Inc |
Issue Date: | 2000 |
ISSN: | 1064-1955 1525-6065 |
Statement of Responsibility: | Antoinette C. Bolte, Gustaaf A. Dekker, Jim van Eyck, Rob Strack van Schijndel, and Herman P. van Geijn |
Abstract: | <h4>Objective</h4>To establish if agreement exists between central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) measurements in severe hypertension in pregnancy as analyzed by tests of bias, precision, and 95% limits of agreement.<h4>Methods</h4>In a prospective study, CVP and PCWP data in 30 patients were collected by means of a pulmonary artery catheter from initiation of therapy until delivery. Patients with a diastolic blood pressure of more than 110 mm Hg were included. Correlation and agreement between CVP and PCWP before and after treatment were evaluated.<h4>Results</h4>The correlation coefficient (r) for CVP-PCWP data in 30 untreated patients was r = 0.64 (p = 0.0002) and for 256 pairs of posttreatment data, it was r = 0.53 (p < 0.0001). Linear regression and correlation for each individual patient in 29 patients with more than 3 measurements showed a significant correlation (p < 0.05) in 19 patients (66%). Correlation was poor (p > 0.05) in 10 patients (34%). The mean difference between PCWP and CVP was 3.5 +/- 2.6 mm Hg (limits of agreement: -1.6 to 8.7) in untreated patients. The mean difference between PCWP and CVP for 256 pairs of data derived posttreatment was 4.9 +/- 3.8 mm Hg (limits of agreement: -2.7 to 12. 5).<h4>Conclusion</h4>Invasive measurements of CVP and PCWP were found to agree poorly. Until a reliable noninvasive method is available to measure left ventricular preload, PCWP is the measurement of choice when invasive hemodynamic monitoring is necessary in patients with severe preeclampsia. |
Keywords: | Humans Pre-Eclampsia Succinates Gelatin Monitoring, Physiologic Linear Models Sensitivity and Specificity Prospective Studies Pregnancy Blood Pressure Pulmonary Wedge Pressure Central Venous Pressure Diastole Female Bias |
DOI: | 10.1081/PRG-100101987 |
Published version: | http://dx.doi.org/10.1081/prg-100101987 |
Appears in Collections: | Aurora harvest 4 Obstetrics and Gynaecology publications |
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