Infradiaphragmatic central venous pressures reflect supradiaphragmatic pressures in stable burn patients

Objective: Because the skin of the groin is often spared, femoral central v enous catheters are sometimes used in patients with extensive burns. The ac curacy of central venous pressures obtained from the infradiaphragmatic loc ation relative to the traditional supradiaphragmatic value is not known in this population. Methods: Seventeen seriously injured but hemodynamically stable burn patien ts were enrolled in a protocol approved by the human studies committee in w hich, during scheduled central venous line rotations, supradiaphragmatic an d infradiaphragmatic central venous pressures were determined simultaneousl y, Results: These 17 patients were an average of 21.8 +/- 20.1 years old (rang e, 6 months to 61 years), and the average burn size was 60.8 +/- 22.6% (ran ge, 20 to 90%). Supradiaphragmatic and infradiaphragmatic pressures correla ted well, with an r value of 0.903, p less than 0.01, Conclusion: In the absence of clinically significant abdominal distention, infradiaphragmatic central venous pressure is an accurate reflection of sup radiaphragmatic pressure, and indirectly, circulating blood volume.