Contributor: Steven Stroud
Bedside assessment of volume status is an age-old practice for clinicians. Spoiler alert: we are not very good at it. So, is there an alternate, accurate, less invasive way to assess volume status in decompensated heart failure patients other than measurement of central hemodynamics? Well, every hospitalized patient gets (at least) one peripheral intravenous (IV) line. What if we transduced the peripheral venous pressure (PVP) to estimate central venous pressure (CVP)? Sperry and colleagues demonstrated that PVP was highly correlated with CVP (r=0.947). OK, but does that help me estimate pulmonary catheter wedge pressure (PCWP)? PVP was mildly correlated (r=0.57) with PCWP, but patients with PVP >10mmHG did have a 100% positive predictive value of PCWP >20mmHg (n=13). Big news— worry less about keeping batteries in that little flashlight for the neck exam.