Understanding central venous pressure: not a preload index?

Current Opinion in Critical Care
Sheldon Magder

Abstract

Critical care physicians frequently try to manipulate the preload of the heart to optimize cardiac function. There is, however, still debate as to what actually indicates the preload of the heart. Although central venous pressure (CVP) is commonly used to estimate cardiac filling, it is often argued that it is a poor indicator of preload. This is likely true if one does not understand what preload is, principles of measurement with fluid filled systems, the effect of respiratory efforts on the measurement, the physiological determinants of CVP, and finally which point on the tracing to use as the estimate of the preload of the heart. When these are considered, however, the value of the CVP at the base of the 'c' wave gives a good indication of cardiac preload and a value which can be followed. When properly measured CVP can be a useful guide to the filling status of the right ventricle. CVP is especially useful when followed over time and combined with a measurement of cardiac output. Importantly, preload is only one of the factors determining cardiac output and it must be integrated into a comprehensive approach that takes into account changes in cardiac function and the return of blood to the heart. Finally, the specific valu...Continue Reading

References

Jul 1, 1992·Archives of Surgery·L N DiebelR A Kline
Sep 1, 1985·Journal of Molecular and Cellular Cardiology·D G Allen, J C Kentish
Mar 7, 1998·American Heart Journal·C F NotariusS Magder
Jul 11, 1998·Critical Care Medicine·S Magder, B De Varennes
Jun 2, 2005·Current Opinion in Critical Care·Sheldon Magder
Jun 10, 2006·Critical Care Medicine·Sheldon Magder
Oct 31, 2012·Critical Care : the Official Journal of the Critical Care Forum·Sheldon Magder
Dec 19, 2012·Archives of Biochemistry and Biophysics·Eun-Jeong LeeHenk L Granzier
Jun 25, 2013·The European Respiratory Journal·Gabor KovacsHorst Olschewski

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Citations

Jan 29, 2016·Intensive Care Medicine·S Magder
Mar 26, 2016·JACC. Cardiovascular Interventions·Saraschandra VallabhajosyulaSunil V Mankad
Jun 10, 2016·Critical Care : the Official Journal of the Critical Care Forum·David Berger, Jukka Takala
May 29, 2018·Emergency Medicine Journal : EMJ·Tim HarrisMohammed H Elwan
Sep 18, 2018·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Brett G SampsonMarianne J Chapman
Feb 23, 2019·The Journal of Experimental Biology·William JoyceTobias Wang
Apr 26, 2020·Current Opinion in Critical Care·Thomas KaufmannThomas W L Scheeren
May 2, 2017·European Journal of Anaesthesiology·Benedikt H SieglerMarkus A Weigand
Feb 1, 2018·Nursing Standard·Barry Thomas Hill
Oct 4, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Federico MercoliniAlvise Tosoni
Apr 2, 2021·Annals of the American Thoracic Society·Rubabin ToobaAdriano R Tonelli
May 6, 2021·Journal of Anesthesia·Michael F GraesslerConstantin J C Trepte

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Methods Mentioned

BETA
imaging techniques

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