The correlation between CVP-derived parameters and the prognosis of critically ill patients


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Abstract

ObjectiveTo investigate the effect of central venous pressure on the organ dysfunction and prognosis of critically ill patients.MethodsWe conducted a retrospective observational cohort study of 488 ICU patients with central venous pressure and its derived parameters in a half-year period in one single ICU centre to compare the length of ICU stay, critical illness scores (SOFA and APACHE II), serum creatinine and lactate levels.ResultsThe initial, peak and mean CVP levels of critically ill patients and length of ICU stay, peak lactate levels and SOFA scores were significantly correlated. While the peak CVP and peak creatinine levels were significantly correlated, the correlation of initial and mean CVP levels with peak creatinine was not significant. Subgroup analysis showed that in the patients with a peak CVP value above 12 mm Hg, the length of stay was significantly prolonged, organ function was significantly worse, and the SOFA score was significantly higher. ROC analysis showed peak levels of CVP above 11.5 mm Hg had the greatest ability to predict mortality of critically ill patients.ConclusionExposure to higher levels of central venous pressure in critically ill patients is associated with a poorer prognosis and worse organ function. Therefore, central venous pressure should be kept as low as possible during hemodynamic therapy in critically ill patients.HighlightsThe peak value of CVP have the greatest correlation strength with the ICU length of stay and prognosis compared with initial and average values.Subgroup analysis showed patients with CVP > 12 had a longest ICU hospital stay and worst organ dysfunction.The best predictablility of peak CVP for 30-day mortality is 11.5 mm Hg.Maintaining CVP as low as possible throughout treatment could be a better choice.

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