[Central venous pressure. Variations in patients with intolerance to supine decubitus]

An accurate measure of central venous pressure has great clinical value; although at times due to causes inherent in the pathology of a patient this cannot be measured be the utmost conditions. The position a patient has in bed invariably affects the final measurement of central venous pressure in that patient. It is important to bear this in mind for patients who do not tolerate a supine position, such as those with polytraumatic injuries. The authors studied the variations in central venous pressure values taken on the same patient when he was in a supine position and when he had his bed inclined 45; the authors opted for an analytical study using 1061 measurements on patients checked into the intensive care ward at the Nuestra Señora de Fatima Clinic in Seville. The correct placement of the central catheter, either clavicle, jugular or "DRUM" placement, was confirmed by means of radiological testing in each of these patients. After obtaining these central venous pressure measurement values, the authors related these to the patient's corporal mass index, a comparison of weight in kilograms to height en square meters; they observed that when a patient's corporal volume is greater, greater is the difference between the measurements in a supine position and with bed inclined 45 degrees, in favor of the first measurement.