Central Venous Pressure or CVP in short, is defined as the pressure in the central veins (internal jugular, subclavian or femoral). Basically, it is referred to as the blood pressure in the proximal SVC, near the junction with the right atrium.
Usually, measurement of CVP is recommended for patients with hypotension who are not responding to basic clinical management; has continuing hypovolaemia secondary to major fluid shifts or loss and those who require infusions of inotropes. CVP may also be used to diagnose right ventricular infarction, PE, ARDS, cor pulmonale and tamponade. However, it cannot be used to assess fluid responsiveness as there is very poor relationship between CVP and blood volume, and CVP/DeltaCVP is a poor predictor of the hemodynamic response to a fluid challenge.
CVP can be measured using an indwelling central venous catheter and either manually using a pressure manometer or electronically using a transducer. Usually, the manometer is used especially in wards. But in both ways, it must be ‘zeroed’ at the level of the right atrium. You may do this by taking it at level of the 4th intercostal space in the mid-axillary line while the patient is lying supine, each time at the same zero position.
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