scholarly journals Neutralising Neurophobia

2018 ◽  
Vol 60 (1) ◽  
pp. 41-43
Author(s):  
Greg Lamb
Keyword(s):  
Medical Students ◽  
Mitral Valve ◽  
Central Venous Pressure ◽  
Mitral Valve Prolapse ◽  
Venous Pressure ◽  
Basic Sciences ◽  
Central Venous ◽  
Progressive Decline ◽  
Electrical Oscillation

Medical students are being trapped in the void between basic sciences and clinical facts. Of greater concern is that the chasm is widening with the progressive decline of the basic sciences, which require years to master. Meanwhile we expect our doctors to disperse quickly and start righting the wrongs. Teaching laboratories are becoming more sophisticated in order for students to be able to intubate and put up CVP (central venous pressure) lines unsupervised. Cardiac murmurs are digitalised, recorded and replayed. Mitral valve prolapse is an electrical oscillation of red lights and not the whooping of a white dove. The experience is made as real as possible and becomes ever more surreal. Medicine becomes performance based and frozen. The patella hammer rests on top of the book.

Variability in the establishment of an external reference point for central venous pressure measurement in children

2006 ◽  
Vol 0 (0) ◽  
Author(s):  
Aline S. C. Belela ◽  
Mavilde L. G. Pedreira ◽  
Maria Angélica S. Peterlini ◽  
Denise M. Kusahara ◽  
Werther B. Carvalho ◽  
...  
Keyword(s):  
Central Venous Pressure ◽  
Pressure Measurement ◽  
Reference Point ◽  
Venous Pressure ◽  
Central Venous ◽  
External Reference

Central venous pressure monitoring in critical care settings

2021 ◽  
Vol 30 (4) ◽  
pp. 230-236
Author(s):  
Barry Hill ◽  
Catherine Smith
Keyword(s):  
Critical Care ◽  
Central Venous Pressure ◽  
Right Atrium ◽  
Venous Pressure ◽  
Vena Cava ◽  
Alternative Methods ◽  
Haemodynamic Monitoring ◽  
Haemodynamic Instability ◽  
Central Venous ◽  
The Right

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.

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

2012 ◽  
pp. 181-184 ◽  
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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