Renal failure in critically ill patients, beware of applying (central venous) pressure on the kidney

Annals of Intensive Care
Xiu-kai ChenDa-wei Liu

Abstract

The central venous pressure (CVP) is traditionally used as a surrogate of intravascular volume. CVP measurements therefore are often applied at the bedside to guide fluid administration in postoperative and critically ill patients. Pursuing high CVP levels has recently been challenged. A high CVP might impede venous return to the heart and disturb microcirculatory blood flow which may cause tissue congestion and organ failure. By imposing an increased "afterload" on the kidney, an elevated CVP will particularly harm kidney hemodynamics and promote acute kidney injury (AKI) even in the absence of volume overload. Maintaining the lowest possible CVP should become routine to prevent and treat AKI, especially when associated with septic shock, cardiac surgery, mechanical ventilation, and intra-abdominal hypertension.

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Jan 17, 2020·Journal of Cardiac Surgery·Risa ShimboriToshihiro Fukui
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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

ProCESS
ProMISE
ARISE

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