[Comparison of central venous and peripheral venous pressures in the antecubital region in coronary arterial bypass graft surgery]

Previous studies suggest a correlation of central venous pressure [CVP] and peripheral venous pressure [PVP] in different surgeries. CVP is one of essential monitoring during coronary arterial bypass graft [CABG]. Canulation of peripheral venous catheter and PVP measurement is easier, whit less complication. This study was done to compare the central venous and peripheral venous pressures in the antecubital region in coronary arterial bypass graft surgery. This descriptive analytical study was done on 84 patients with American society of anesthesiology III with CABG surgery in Shafa hospital, Kerman, Iran during 2007. The technique of anesthesia was the same in all patients. CVP and PVP were measured every 20 minutes intervals before, on and after cardio-pulmonary pump. Data were analyzed using STAT-10, ANOVA and linear regression tests. A total of 750 simultaneous measurements of CVP and PVP were recorded in all patients. The mean of CVP before of pump was 6.8 +/- 0.9 and the mean of PVP was 8.8 +/- 1. The mean difference between CVP and PVP was +/- 2 mmHg and this difference was significant [P<0.05]. The mean of CVP on pump was 3.9 +/- 1 and the mean on PVP was 7.6 +/- 1. The mean difference of these two changeable was +/- 3.7 mmHg. This difference was significant [P<0.05]. The mean of CVP after of pump was 6.5 +/- 1 and the mean of PVP was 8.5 +/- 1. The mean difference this two changeable was +/- 2 mmHg and this difference was significant [P<0.05]. PVP and CVP are related with each other on cardio-pulmonary pump even in severe hemodynamic condition. PVP and CVP changes are synchronized and PVP is a helpful clinical alternative for estimation of CVP

Increasing serum troponin I and early prognosis in patients with chest pain or angina equivalent symptoms in the emergency department

The purpose of this research was to determine the relation between negative or positive qualitative troponin I test and the short term prognosis of patients presenting to emergency department with chest pain or angina equivalent symptoms. We assessed the qualitative rapid troponin I in patients with chest pain or angina equivalent symptoms after at least 4 hours and then we followed the patients in 72 hours after presentation for adverse events such as death, CCU admission, fatal arrhythmias and heart failure. After comparing qualitative troponin I test results and adverse events, we concluded that the troponin I was significantly more positive in patients with adverse events [i.e. CCU admission, fatal arrhythmias and heart failure] [P=0.031]. A single measurement of rapid qualitative troponin I test can be used as a prognostic factor in patients with chest pain or angina equivalent symptoms and also as a device for risk stratification of moderate and high risk patients