The role of femoral venous pressure and femoral venous oxygen saturation in the setting of intra-abdominal hypertension: A pig model

Authors

Adrian Regli, University of Notre Dame AustraliaFollow
Bart L. De Keulenaer
Lisen E. Hockings
Gabrielle C. Musk
Brigit Roberts
Peter V. van Heerden

Publication Details

Regli, A., De Keulenaer, B., Hockings, L. E., Musk, G. C., Roberts, B., & van Heerden, P. V. (2011). The role of femoral venous pressure and femoral venous oxygen saturation in the setting of intra-abdominal hypertension: A pig model. Shock, 35(4), 422-427. doi:10.1097/SHK.0b013e3181fddf45

Abstract

Femoral venous access is frequently used in critically ill patients. Because raised intra-abdominal pressure (IAP) is also frequently found in this group of patients, we examined the impact of IAP and positive end-expiratory pressure (PEEP) on femoral venous pressure (FVP) and femoral venous oxygen saturation (Sfvo₂) in an animal model. Thirteen adult pigs received standardized anesthesia and ventilation. Randomized levels of IAP (3 [baseline], 18, and 26 mmHg) were applied, with levels of PEEP (5, 8, 12, and 15 cmH₂O) applied randomly at each IAP level. We measured bladder pressure (IAP), superior vena cava pressure, pulmonary artery pressure, pulmonary artery occlusion pressure, FVP, mixed venous oxygen saturation (Svo₂), and Sfvo₂. We found that FVP correlated well with IAP (FVP = 4.1 + [0.12 × PEEP] + [1.00 × IAP]; R² = 0.89, P < 0.001) with a moderate bias and precision of 5.0 and 3.8 mmHg, respectively. Because the level of agreement did not meet the recommendations of the World Society of Abdominal Compartment Syndrome, FVP cannot currently be recommended to measure IAP, and further clinical trials are warranted. However, a raised FVP should prompt the measurement of the bladder pressure. Femoral venous oxygen saturation did correlate neither with Svo₂ nor with abdominal perfusion pressure. Therefore, Sfvo₂ is of no clinical use in the setting of raised IAP.

Keywords

peer-reviewed