Central venous pressure

Central Venous Pressure

Central venous pressure (CVP) is a critical physiological parameter that reflects the pressure in the thoracic vena cava near the right atrium of the heart. It is an important indicator of a patient's blood volume status and cardiac function, particularly in critically ill patients. CVP is often used in the management of patients in intensive care units and during major surgeries.

Physiology

CVP is determined by the volume of blood returning to the heart (venous return) and the ability of the heart to pump the blood into the arterial system. It is influenced by several factors, including:

• Blood Volume: An increase in blood volume can elevate CVP, while a decrease can lower it.
• Venous Tone: Changes in the tone of the venous system can affect CVP.
• Right Ventricular Function: The ability of the right ventricle to pump blood affects CVP.
• Intrathoracic Pressure: Changes in intrathoracic pressure, such as those caused by mechanical ventilation, can influence CVP readings.

Measurement

CVP is typically measured using a central venous catheter inserted into a large vein, such as the internal jugular or subclavian vein. The catheter is advanced until its tip is positioned in the superior vena cava or right atrium. The pressure is then measured using a manometer or a transducer connected to a monitor.

Clinical Significance

CVP is used to assess:

• Fluid Status: High CVP may indicate fluid overload, while low CVP may suggest hypovolemia.
• Cardiac Function: Elevated CVP can be a sign of right heart failure or pulmonary hypertension.
• Guiding Fluid Therapy: CVP measurements can help guide fluid resuscitation in critically ill patients.

Limitations

While CVP can provide valuable information, it has limitations:

• Variability: CVP can be influenced by factors such as patient position and intrathoracic pressure changes.
• Interpretation: CVP should be interpreted in the context of the overall clinical picture and other hemodynamic parameters.

Also see

• Pulmonary artery pressure
• Cardiac output
• Venous return
• Right atrial pressure
• Fluid resuscitation

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A

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B

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I

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