Central Venous Pressure and Peripheral Venous Pressure with Passive Leg Raise in Patients on Mechanical Ventilation
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58 Indian Journal of Critical Care Medicine January 2016 Vol 20 Issue 1 Conflicts of interest 4. Rosen T, Fordice DB. Cashew nut dermatitis. South Med J There are no conflicts of interest. 1994;87:543-6. 5. Wang D, Girard TJ, Kasten TP, LaChance RM, Miller-Wideman MA, Durley RC. Inhibitory activity of unsaturated fatty acids and anacardic Balaji Balasubramanian, acids toward soluble tissue factor-factor VIIa complex. J Nat Prod 1998;61:1352-5. Khaja Mohideen Sherfudeen, Senthil Kumar Kaliannan, This is an open access article distributed under the terms of the Creative Karthikeyan Murugesan Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows Department of Anaesthesiology and Critical Care, Kauvery Hospital, others to remix, tweak, and build upon the work non-commercially, as long as the Trichy, Tamil Nadu, India author is credited and the new creations are licensed under the identical terms. Correspondence: Access this article online Dr. Khaja Mohideen Sherfudeen, Quick Response Code: Department of Anaesthesiologist and Critical Care, Website: Kauvery Hospital, No 1, K.C Road, Tennur, Trichy - 620 017, Tamil Nadu, India. www.ijccm.org E-mail: [email protected] References DOI: 10.4103/0972-5229.173696 1. Asogwa EU, Mokwunye IU, Yahaya LE, Ajao AA. Evaluation of cashew nut shell liquid (CNSL) as a potential natural insecticide against termites (soldiers and workers castes). Res J Appl Sci 2007;2:939-42. 2. Tyman JH, Johnson RA, Muir M, Rokhgar R. The extraction of natural cashew nut-shell liquid from the cashew nut (Anacardium occidentale). J Am Oil Chem Soc 1989;66:553-7. How to cite this article: Balasubramanian B, Sherfudeen KM, Kaliannan SK, 3. Todorovic V. Acute phenol poisoning. Med Pregl 2003;56 Suppl 1:37-41. Murugesan K. Cashew nut shell liquid poisoning. Indian J Crit Care Med 2016;20:57-8. Central venous pressure diastolic pressure of the right ventricle. Very low values of CVP <7 mm H2O predicted a positive response to fluid loading.[3] However, for values between 5 and 15 mm and peripheral venous Hg the gray-zone approach should be applied, so as to increase the utility of diagnostic measures.[4] This means pressure, however that doctors should be aware that their measurements may be inconclusive in approximately 25% of patients correlated are still both for prediction of fluid responsiveness. in the gray‑area Second, as underlined by Peyton and Chong, a percentage error of 30% or less for cardiac output Sir, monitoring is unrealistic.[5] The authors concluded that In their prospective observational study Kumar a percentage error in agreement with thermodilution et al. demonstrated an acceptable correlation between of ±45% represented a more realistic expectation of central venous pressure (CVP) and peripheral venous achievable precision in clinical practice. [1] pressure (PVP), especially when CVP >10 cm H2O. They proposed to use PVP measurement to guide fluid As regards as the golden hour concept in sepsis therapy in a wide variety of critically ill patients. Whereas management, the methods presented by Kumar et al. being of very high interest for clinicians, we would like have the advantage of being easy to use. In this view, an to underline some drawbacks that may prevent the end-point clinical survey using PVP in early treatment efficient use of PVP. of sepsis would be very interesting. First, several studies have shown that CVP was not Financial support and sponsorship a reliable indicator of cardiac preload and a review of Institutional grant from Begin Military Hospital. literature concluded in 2008 that CVP should not be used to guide fluid management.[2] This might be too restrictive Conflicts of interest because the physiology tells us that CVP reflects the There are no conflicts of interest. Indian Journal of Critical Care Medicine January 2016 Vol 20 Issue 1 59 Matthieu Pissot, Alexandre Salvadori, for the prediction of fluid responsiveness: A “gray zone” approach. Anesthesiology 2011;115:231-41. Kevin Kearns, Clement Dubost 5. Peyton PJ, Chong SW. Minimally invasive measurement of cardiac Department of Anaesthesiology and Intensive Care Medicine, Begin Military output during surgery and critical care: A meta-analysis of accuracy Hospital, 69, Avenue de Paris, 94163 Saint-Mandé, France and precision. Anesthesiology 2010;113:1220-35. Correspondence: Dr. Clement Dubost, This is an open access article distributed under the terms of the Creative Department of Anaesthesiology and Intensive Care Medicine, Begin Military Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows Hospital, 69, Avenue de Paris, 94163 Saint-Mandé, France. others to remix, tweak, and build upon the work non-commercially, as long as the E-mail: [email protected] author is credited and the new creations are licensed under the identical terms. References Access this article online Quick Response Code: 1. Kumar D, Ahmed SM, Ali S, Ray U, Varshney A, Doley K. Correlation Website: between central venous pressure and peripheral venous pressure with www.ijccm.org passive leg raise in patients on mechanical ventilation. Indian J Crit Care Med 2015;19:648-54. 2. Marik PE, Baram M, Vahid B. Does central venous pressure predict DOI: 10.4103/0972-5229.173698 fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest 2008;134:172-8. 3. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med Pissot M, Salvadori A, Kearns K, Dubost C. Central venous 2013;41:580-637. How to cite this article: 4. Cannesson M, Le Manach Y, Hofer CK, Goarin JP, Lehot JJ, Vallet B, pressure and peripheral venous pressure, however correlated are still both in the gray- et al. Assessing the diagnostic accuracy of pulse pressure variations area. Indian J Crit Care Med 2016;20:58-9..