Central venous pressure is the pressure recorded from the *right atrium or superior vena cava* and is representative of the filling pressure of the right side of the heart. If the patient is supine, there is *probably *minimal difference between the superior vena cava and femoral CVP measurements, but you are making a lot of assumptions (e.g. no intra abdominal hypertension), and I'd recommend against it.
There is a large body of evidence that the CVP is a poor predictor of ventricular preload and fluid responsiveness. This is a great review article: Marik PE, Baram M, Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest. 2008 Jul;134(1):172-8. doi: 10.1378/chest.07-2331. full text article: http://journal.publications.chestnet.org/article.aspx?articleid=1085950 So, CVP probably has minimal usefulness, and a femoral CVP even less so. There are much better ways to assess fluid responsiveness: passive leg raise, bedside IVC ultrasound, pulse pressure variation... -Andy Andy Bourgeois, MD, FAAEM Allied Emergency Physicians Simi Valley Hospital On Thu, Feb 19, 2015 at 7:05 PM, <[email protected]> wrote: > Hello everyone: > > > > I am the education coordinator in a small community hospital. I am > putting together an education plan for our hospital on the surviving sepsis > campaign. > > > > Our providers tend to place femoral central lines, and I cannot find any > evidence to support using the CVP reading from a femoral central line > verses subclavian or internal jugular placed central line to use as a guide > for fluid resuscitation in sepsis. > > > > If you have any information you have on this topic would be greatly > appreciated. Thank you very much! > > > > Karen Hackenberg, RN, MS, CCRN > > Education Coordinator > > Los Alamos Medical Center > > 3917 West Road > > Los Alamos, NM 87544 > > 505-661-9131 > > > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > >
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