Error in Central Venous Pressure Measurement

BACKGROUND: The variability introduced by inconsistent placement of pressure transducers for invasive monitoring may result in significant measurement error. Our goals in this study were to quantify the degree of variation among health care providers and to identify a simple tool for reducing this error. METHODS: A sample of 50 perioperative health care providers was recruited and asked to place a transducer at the appropriate level for central venous pressure (CVP) monitoring on two separate occasions: first without any additional standardization tools and second with a laser level to guide transducer placement. The variability among providers was calculated, and the results between sessions compared. RESULTS: There was significant variation in transducer placement during both sessions, in some instances, of greater magnitude than a normal CVP value. The laser level did not significantly reduce this variation. CONCLUSION: There is significant variation in transducer placement among health care providers. This variation is not reduced by a laser level and must be considered when interpreting CVP data. Hospital- or institution-wide standardization of a zero-level should be considered.