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Completed

NCT Number: NCT06705374

Central Venous Pressure and Right Atrial Pressure Measurements in Supine, Semi-recumbent and Trendelenburg Position

Intensive care is directed towards patients with severe illness or risk of serious outcomes following, for example, surgery. Central venous pressure (CVP) is an important part of the hemodynamic assessment of patients in surgery and the intensive care unit (ICU). CVP is normally measured via a central venous catheter (CVC) inserted through the subclavian or internal jugular vein, with the tip placed at the junction to the right atrium. A pressure tubing is connected to one of the branches of the CVC and then connected to a pressure sensor that sends a digital signal to the monitoring screen where CVP can be read in mmHg. To accurately read CVP, the pressure sensor must be positioned at the level of the right atrium. Different external reference points are used nationally and internationally to locate the correct height for the pressure sensor. This study aims to investigate the most commonly used external reference points for CVP measurement in various body positions compared to CVP measured via a solid state pressure catheter in the right atrium (RAP).

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Key information

Conditions

Critically Ill Critical Illness Disease Attributes Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Sahlgrenska University Hospital

Gothenburg, Västra Götaland County, 41345, Sweden

About this study

A Millar Mikro-Cath solid state pressure catheter is inserted through one of the medial lines of the CVC and guided in position by the pressure curve and verified in position by ultrasound.

CVP is compared to RAP in supine, semi-recumbent, Trendelenburg and lateral position.

CVP, RAP and arterial pressure is recorded in each session with Biopac Acqnowledge.

In each body position PEEP is raised 5 cmH20 and then lowered 5 cmH20.

Ventilator settings, capillary refill time, perfusion index are collected in each setting and before and after PEEP adjustments.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Critically ill patients in mechanical ventilation with an arterial line and a four or five lumen CVC.

Exclusion criteria

  • under 18 years of age
  • in a dynamic phase of their illness i.e. ongoing treatment of severe circulatory or respiratory failure
  • positive end-expiratory pressure (PEEP) >14 cmH20 or intolerance to change of body position.

Treatment and study plan

Primary outcomes

  1. Difference in mmHg between Right atrial pressure (RAP) and Central venous pressure (CVP) in supine position

    Time frame: 3 minutes after body position change

    Difference in mmHg between RAP (Millar Micro-Cath) and CVP.

  2. Difference in mmHg between RAP and CVP in semi-recumbent position

    Time frame: 3 minutes after body position change

    Difference in mmHg between RAP (Millar Micro-Cath) and CVP.

  3. Difference in mmHg between RAP and CVP in Trendelenburg position

    Time frame: 3 minutes after body position change

    Difference in mmHg between RAP (Millar Micro-Cath) and CVP.

  4. Difference in mmHg between RAP and CVP in right lateral position

    Time frame: 3 minutes after body position change

    Difference in mmHg between RAP (Millar Micro-Cath) and CVP.

  5. Difference in mmHg between RAP and CVP in left lateral position

    Time frame: 3 minutes after body position change

    Difference in mmHg between RAP (Millar Micro-Cath) and CVP.

Secondary outcomes

  1. Change in hemodynamic parameters after body position change

    Time frame: 3 minutes after body position change

    Change in CVP (mmHg)

  2. Change in hemodynamic parameters after PEEP change

    Time frame: 1 minutes after PEEP change

    Change in RAP (mmHg)

  3. Change in hemodynamic parameters after body position change

    Time frame: 3 minutes after body position change

    Change in arterial pressure (mmHg)

  4. Change in hemodynamic parameters after body position change

    Time frame: 3 minutes after body position change

    Change in perfusion index (%)

  5. Change in hemodynamic parameters after body position change

    Time frame: 3 minutes after body position change

    Change in capillary refill time change (sek)

  6. Change in hemodynamic parameters after body position change

    Time frame: 3 minutes after body position change

    Change in RAP (mmHg)

  7. Change in hemodynamic parameters after PEEP change

    Time frame: 1 minutes after PEEP change

    Change in CVP (mmHg)

  8. Change in hemodynamic parameters after PEEP change

    Time frame: 1 minutes after PEEP change

    Change in arterial pressure (mmHg)

  9. Change in hemodynamic parameters after PEEP change

    Time frame: 1 minutes after PEEP change

    In capillary refill time change (sek)

  10. Change in hemodynamic parameters after PEEP change

    Time frame: 1 minutes after PEEP change

    Change in perfusion index (%)

Sponsors and collaborators

Lead sponsor

Vastra Gotaland Region

Other Gov

Registry information

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Nov 26, 2024
Registry last updated
May 20, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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