NONINVASIVE ESTIMATION OF CENTRAL VENOUS PRESSURE IN ANESTHETIZED DOGS BY MEASUREMENT OF HEPATIC VENOUS BLOOD FLOW VELOCITY AND ABDOMINAL VENOUS DIAMETER

摘要

Determination of central venous pressure (CVP) is relevant to patients with right heart disease, hypovolemia, and following intravenous fluid therapy. We hypothesized that changes in CV P in dogs could be predicted by measurements of hepatic vein diameter, caudal vena cava (CVC) diameter, and hepatic venous flow velocities. Nine healthy American Foxhounds were anesthetized. Following baseline recordings, intravenous fluids were administered to increase CV P. Volume administration created treatment periods with CVP ranges of 5, 10, 15, 20, and 25 mm Hg. Flow velocities in the right medial hepatic vein were recorded using pulsed wave Doppler ultrasound. Hepatic vein, CVC, and aorta diameters were determined with B-mode ultrasound. Variables were compared across the treatment periods by ANOVA for repeated measures. Relationships between CVP, Doppler, and B-mode variables were evaluated using Spearman's rank correlations, multiple linear regression, and repeated measures linear regression. The a-, S- and v-wave velocities were augmented significantly with volume loading. The best part (semipartial) correlation coefficients predicting increasing CVP were identified with v-wave velocity (0.823), S-wave velocity (-0.800), CVC diameter (0.855), and hepatic vein diameter (0.815). Multiple linear regression indicated that CVP in this study could be predicted best by a combination of CVC and hepatic vein diameter and the v-wave velocity (r=0.928). Ultrasound imaging identified gallbladder and pancreatic edema consistently, likely related to acute volume loading. These findings may be applicable in the assessment of volume status, dogs with right heart disease, and during serial monitoring of dogs receiving fluid or diuretic therapy.