Afterload Assessment With or Without Central Venous Pressure: A Preliminary Clinical Comparison

Patients who present with acute cardiovascular compromise require haemodynamic monitoring in a critical care unit. Central venous pressure (CVP) is the most frequently used measure to guide fluid resuscitation in critically ill patients. It is most often done via a central venous catheter (CVC) positioned in the right atrium or superior or inferior vena cava as close to the right atrium as possible. The CVC is inserted via the internal jugular vein, subclavian vein or via the femoral vein, depending on the patient and their condition. Complications of CVC placement can be serious, so its risks and benefits need to be considered. Alternative methods to CVC use include transpulmonary thermodilution and transoesophageal Doppler ultrasound. Despite its widespread use, CVP has been challenged in many studies, which have reported it to be a poor predictor of haemodynamic responsiveness. However, it is argued that CVP monitoring provides important physiologic information for the evaluation of haemodynamic instability. Nurses have central roles during catheter insertion and in CVP monitoring, as well as in managing these patients and assessing risks.

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Should we stop using the determination of central venous pressure as a way to estimate cardiac preload?

Colombia Medica ◽

10.25100/cm.v43i2.796 ◽

2012 ◽

pp. 181-184 ◽

Cited By ~ 2

Author(s):

Johann Smith Ceron Arias ◽

Manuel Felipe Muñoz Nañez

Keyword(s):

Central Venous Pressure ◽

Blood Volume ◽

Pulse Pressure ◽

Venous Pressure ◽

Pressure Change ◽

Cardiac Preload ◽

Central Venous ◽

End Diastolic Volume ◽

Dynamic Variables

The determination of the values of central venous pressure has long been used as a guideline for volumetric therapy in the resuscitation of the critical patient, but the performance of such parameter is currently being questioned as an effective measurement of cardiac preload. This has aroused great interest in the search for more accurate parameters to determine cardiac preload and a patient’s blood volume. Goals and Methodology: Based on literature currently available, we aim to discuss the performance of central venous pressure as an effective parameter to determine cardiac preload. Results and Conclusion: Estimating variables such as end-diastolic ventricular area and global end-diastolic volume have a better performance than central venous pressure in determining cardiac preload. Despite the best performance of these devices, central venous pressure is still considered in our setting as the most practical and most commonly available way to assess the patient’s preload. Only dynamic variables such as pulse pressure change are superior in determining an individual’s blood volume.

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EXTERNAL JUGULAR VEIN FOR CENTRAL VENOUS PRESSURE

AJN American Journal of Nursing ◽

10.1097/00000446-200703000-00037 ◽

2007 ◽

Vol 107 (3) ◽

pp. 72LL

Author(s):

Heather Lindsey

Keyword(s):

Central Venous Pressure ◽

Jugular Vein ◽

Venous Pressure ◽

External Jugular Vein ◽

Central Venous

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Is central venous pressure still relevant in the contemporary era of liver resection?

Journal of Surgical Research ◽

10.1016/j.jss.2015.08.005 ◽

2016 ◽

Vol 200 (1) ◽

pp. 139-146 ◽

Cited By ~ 6

Author(s):

Eva See Wah Cheng ◽

Julie Hallet ◽

Sherif S. Hanna ◽

Calvin H.L. Law ◽

Natalie G. Coburn ◽

...

Keyword(s):

Liver Resection ◽

Central Venous Pressure ◽

Venous Pressure ◽

Central Venous

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