Respiratory failure & ventilation
Agreement between central venous pressure and right atrial pressure in critically ill patients: In search of the optimal external reference point – A prospective clinical study
Authors' conclusion
In sedated, mechanically ventilated ICU patients, referencing CVP to one-third of the AP chest diameter showed the closest agreement with directly measured RAP across body positions, whereas fixed sternal angle referencing introduced greater variability and position-dependent error.
Study context
- Population
- Sedated, mechanically ventilated ICU patients; direct right atrial pressure (RAP) measurement by solid-state catheter in mid-right atrium; supine, semi-recumbent (30°) and Trendelenburg (−10°) positions
- Participants
- 16 participants
- Exposure
- One-third anteroposterior (AP) vs One-half AP vs Sternal angle
- Outcome
- Agreement between CVP and RAP (Bland-Altman analysis, ICC, coverage within ±2 mmHg)
Main finding
As reported in the abstract
Agreement of CVP with RAP across body positions
| Group | Bias | Intraclass correlation coefficients (ICC) | Values within ±2 mmHg | Overestimation of RAP | Limits of agreement, semi-recumbent | Measurements within ±2 mmHg, semi-recumbent and Trendelenburg |
|---|---|---|---|---|---|---|
| One-third AP | −0.9 to −0.1 mmHg | 0.79-0.90 | 94-100% | |||
| One-half AP | ≈1-2 mmHg | |||||
| Sternal angle | −7.8 to +2.2 mmHg | 31-44% |
Bias
One-third AP−0.9 to −0.1 mmHg
One-half AP— not stated in the abstract
Sternal angle— not stated in the abstract
Intraclass correlation coefficients (ICC)
One-third AP0.79-0.90
One-half AP— not stated in the abstract
Sternal angle— not stated in the abstract
Values within ±2 mmHg
One-third AP94-100%
One-half AP— not stated in the abstract
Sternal angle— not stated in the abstract
Overestimation of RAP
One-third AP— not stated in the abstract
One-half AP≈1-2 mmHg
Sternal angle— not stated in the abstract
Limits of agreement, semi-recumbent
One-third AP— not stated in the abstract
One-half AP— not stated in the abstract
Sternal angle−7.8 to +2.2 mmHg
Measurements within ±2 mmHg, semi-recumbent and Trendelenburg
One-third AP— not stated in the abstract
One-half AP— not stated in the abstract
Sternal angle31-44%
Observational data: associations, not effects.
Further findings
RAP change with body position
- RAP decreased in semi-recumbent and increased in Trendelenburg position
- both p < 0.01
Original publication
Agreement between central venous pressure and right atrial pressure in critically ill patients: In search of the optimal external reference point – A prospective clinical study. J Crit Care. Published 29 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →