2017-4-3

Burcu Azapoglu Kaymak et al.
BOĞAZİÇİ TIP DERGİSİ; 2017; 4 (3):117-120 - Doi: 10.15659/bogazicitip.17.10.743
To prevent differences during both CVP and
sonographic measures, positive pressure was
interrupted temporarily in patients who were
ventilated in PEEP mode.
Statistical analysis was done using SPSS 16.0
(IBM, Armonk, New York, United States). One
way ANOVA followed by Tukey and Bonferroni
multiple comparison tests were used to
determine the significance of the differences
between groups. ANOVA and Student’s t test
were used to investigate the significance of differences
observed between group pairs.
RESULTS
Forty patients were enrolled in the study
that were admitted to the intensive care unit during
the study period and mechanically ventilated
with central venous catheters in place.
Out of the 40 patients with central venous catheters,
65 percent were subclavian, 22.5 percent
were jugular, and 12.5 percent were femoral
catheters. 60 percent of patients were male.
The mean age was 65.10±18.70 years.
The reasons for being admitted to intensive
care unit was are shown in Table 1.
Malignancy detected as most common disease
(n=13) in 40 patients. Cardiac disorders
(n=12), Chronic Obstructive Pulmonary Disease
(COPD)-pneumonia (n=8) were other
common disorders. Some patients had multiple
diseases.
Mean arterial blood pressure was 86.80±20.40
mmHg; mean heart rate was 90.77±12.57 beats/minute.
In the evaluation of all cases mean APACHE
score was 17.59±7.4.
Mean CVP values for the three groups
were: 3.71±2.42mmHg for group 1 (n=19),
14.67±2.67mmHg for group 2 (n=14), and
26.43±5.38mmHg for group 3 (n=7).
Distribution of hemodynamic values, APAC-
HE scores, age, sex, and weight by group are
shown in Table 2. There was no statistically
significant difference between these groups.
The correlation between the ratio of IJV: CCA
sonographic area measurements were evaluated
through CVP groups based on ratio 1 and
ratio 2. For ratio 1 the mean ratio was 2.26 for
group 1 (min-max 1.53-2.99), 3.18 for group
2 (min-max 2.30-4.05), and 2.87 for group 3
-119-
(min-max 2.32-3.44) with no statistically significant
differences. For ratio 2 the mean value
was 1.18 for group 1 (min-max 0.72-1.64), 2.64
for group 2 (min-max 1.73-3.55), and 3.00 for
group 3 (min-max 0.97-5.03). For ratio 2, group
1 had a lower value than group 2 (p=0.020) and
group 3 (p=0.021). No significant differences
were observed between groups 2 and 3 (Table
3). There was no statistically significant difference
between groups in relation with three different
types of CVCs (subclavian, jugular, and
femoral) were used.
In group 1, the evaluation of ratio 1 and ratio
2 values showed that they were significantly
lower as compared to the other groups (f
(2,37)=4,454, p=0,018).
Correlation Coefficient (r) evaluated of the groups,
the r values were determined as; group 1:
-0.241, group 2: -0.078 and group 3: 0.420. As
this results suggest, the most meaningful relationship
of ratio 1 and ratio 2 was observed in
group 3. However, there was no significant differences
between them.
Table 1. The number of the patient’s diagnosis.
Diagnosis
No (n=)
Malignancy 13
CHF £ , Acute coronary syndrome 12
COPD ¥ , Pneumonia, 8
Sepsis 7
Renal failure 4
Stroke 4
Trauma 3
Pulmonary thromboembolism 2
£CHF: Congestive Heart Failure
¥COPD: Chronic Obstructive Pulmonary Disease
Table 2. Distribution of hemodynamic values, APACHE scores, age, sex,
weight data’s into the groups.
Group 1 Group 2 Group 3
Age 64.74±21.72 66.82±9.45 69.14±13.51
Sex (m/f) % 57.9/42.1 64.3/37.7 57.1/42.9
Weight (kg) 72.21±21.31 76.45±15.08 78.57±35.67
BP MAP(mmHg) 86.93±16.57 76.80±21.90 96.66±25.10
Pulse(beats/min) 87.95±13.95 96.08±8.32 88.86±14.51
APACHE 14.79±7.3 22.55±6.5 19.43±6.7
Table 3. IJV/CCA area ratio in the groups in supine and 45˚ lying position.
Ratio 1 Ratio 2
Mean
Minimummaximum
Mean Minimummaximum
Group 1 2.26 1.53-2.99 1.18 £ 0.72-1.64
Group 2 3.18 2.30-4.05 2.64 1.73-3.55
Group 3 2.87 2.32-3.44 3.01 0.97-5.03
£ p =0.020 between group 1 and group 2; p=0.021 between group 1 and group
3 in ratio 2.