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Revista Brasileira de Anestesiologia

Print version ISSN 0034-7094


OLIVEIRA FILHO, Getúlio Rodrigues de et al. Acromion-clavicular joint as an alternative reference point for the phlebostatic level. Rev. Bras. Anestesiol. [online]. 2001, vol.51, n.6, pp.511-517. ISSN 0034-7094.

BACKGROUNDS AND OBJECTIVES: The phlebostatic level corresponds to the medium point of the anterior-posterior thoracic diameter at the level of the 4th intercostal space. It is the standard reference point for central venous pressure zero level. In general, the access to the lateral aspect of the thorax is impossible during anesthesia. This study aimed at building an equation to estimate the phlebostatic level based on anthropometric variables and the acromion-clavicular joint level. METHODS: Participated in this prospective study 200 patients who were distributed in two groups. Group 1 was used for building the predictive equation. Group 2 was used for the validation of its predictive capability. Anthropometric data were collected. Phlebostatic level and acromion-clavicular joint height were measured in the supine position. Multiple linear regression was used in Group 1, with phlebostatic level as the dependent variable, and anthropometric variables, as well as acromion-clavicular joint height, as independent variables. Bland-Altman method was used in Group 2 to test the agreement between the observed and estimated phlebostatic level values. RESULTS: Group 1 resulting equation was: phlebostatic level = 49.57 + (0.19 x age) + (0.31 x weight) + (0.20 x acromion-clavicular joint height). Mean difference in Group 2 between estimated and observed phlebostatic levels was 2.79 ± 7.62 mm. CONCLUSIONS: The equation presented in this study can accurately predict the phlebostatic level.

Keywords : MONITORING [central venous pressure]; MONITORING [phlebostatic level].

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