Central Venous Pressure and Right Atrial Pressure Measurements in Supine, Semi-recumbent and Trendelenburg Position

Completed

• Conditions: Critically Ill

• Registration Number: NCT06705374
• Lead Sponsor: Vastra Gotaland Region

Brief Summary

Intensive care is directed towards patients with severe illness or risk of serious outcomes following, for example, surgery. Central venous pressure (CVP) is an important part of the hemodynamic assessment of patients in surgery and the intensive care unit (ICU). CVP is normally measured via a central venous catheter (CVC) inserted through the subclavian or internal jugular vein, with the tip placed at the junction to the right atrium. A pressure tubing is connected to one of the branches of the CVC and then connected to a pressure sensor that sends a digital signal to the monitoring screen where CVP can be read in mmHg. To accurately read CVP, the pressure sensor must be positioned at the level of the right atrium. Different external reference points are used nationally and internationally to locate the correct height for the pressure sensor. This study aims to investigate the most commonly used external reference points for CVP measurement in various body positions compared to CVP measured via a solid state pressure catheter in the right atrium (RAP).

Detailed Description

A Millar Mikro-Cath solid state pressure catheter is inserted through one of the medial lines of the CVC and guided in position by the pressure curve and verified in position by ultrasound.

CVP is compared to RAP in supine, semi-recumbent, Trendelenburg and lateral position.

CVP, RAP and arterial pressure is recorded in each session with Biopac Acqnowledge.

In each body position PEEP is raised 5 cmH20 and then lowered 5 cmH20.

Ventilator settings, capillary refill time, perfusion index are collected in each setting and before and after PEEP adjustments.

Study Timeline

• Study Start: 2023-11-15
• Study First Submitted: 2024-04-30
• Study First Submitted QC: 2024-11-21
• Study First Posted: 2024-11-26
• Primary Completion: 2024-12-15
• Study Completion: 2024-12-30
• Status Verified: 2025-05
• Last Update Submitted: 2025-05-14
• Last Update Posted: 2025-05-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 16

Inclusion Criteria

• Critically ill patients in mechanical ventilation with an arterial line and a four or five lumen CVC.

Exclusion Criteria

• under 18 years of age
• in a dynamic phase of their illness i.e. ongoing treatment of severe circulatory or respiratory failure
• positive end-expiratory pressure (PEEP) >14 cmH20 or intolerance to change of body position.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Difference in mmHg between Right atrial pressure (RAP) and Central venous pressure (CVP) in supine position	3 minutes after body position change	Difference in mmHg between RAP (Millar Micro-Cath) and CVP.
Difference in mmHg between RAP and CVP in semi-recumbent position	3 minutes after body position change	Difference in mmHg between RAP (Millar Micro-Cath) and CVP.
Difference in mmHg between RAP and CVP in Trendelenburg position	3 minutes after body position change	Difference in mmHg between RAP (Millar Micro-Cath) and CVP.
Difference in mmHg between RAP and CVP in right lateral position	3 minutes after body position change	Difference in mmHg between RAP (Millar Micro-Cath) and CVP.
Difference in mmHg between RAP and CVP in left lateral position	3 minutes after body position change	Difference in mmHg between RAP (Millar Micro-Cath) and CVP.

Secondary Outcome Measures

Name	Time	Method
Change in hemodynamic parameters after body position change	3 minutes after body position change	Change in RAP (mmHg)
Change in hemodynamic parameters after PEEP change	1 minutes after PEEP change	Change in perfusion index (%)

Trial Locations

Locations (1)

Sahlgrenska University Hospital; 🇸🇪 Göteborg, Västra Götaland, Sweden