Can Doppler systemic venous flow indices predict central venous pressure in children?

Tricuspid valve, superior vena cava (SVC), and hepatic vein Doppler pattern s may be abnormal in right heart anomalies and have been used to predict hi gh central venous pressure (CVP) in adults. The purpose of this study was t o evaluate the relationship of these systemic venous flow indices to CVP in children. Children undergoing cardiac catheterization were studied prospec tively using simultaneous recordings of mean CVP with pulsed-Doppler tracin gs of SVC, hepatic vein, and tricuspid valve flow. Systemic venous Doppler measurements included peak velocities and velocity time integrals for ventr icular systole (S), ventricular diastobe (D) end ventricular systole (B), a nd atrial systole (A). Tricuspid inflow Doppler E and A waves were recorded also. Patients with significant tricuspid stenosis or regurgitation, syste mic venous obstruction, and nonsinus rhythm were excluded. The 42 patients ranged in, age from 0.2 to 21.0 years and in weight from 3.0 to 68.0 kg. Me an. CVPs ranged from I to 17 mmHg. Catheterization indications included hem odynamic evaluation (25 patients), transplant biopsy, (11 patients), and in terventional procedures (6 patients). No SVC or tricuspid valve Doppler mea surement correlated with CVP. Hepatic vein peak D, peak B, and peak A signi ficantly correlated with CVP (r = 0.34-0.55; P < 0.05 linear regression). F or all correlations, the r values were low with significant overlap among p atients. Thus, in children, only hepatic vein peak velocities correlate wit h CVP. Because of the lour r values and significant overlap among patients, the currently used Doppler indices have a low sensitivity for predicting C VP in this age group.