Karen, a perspective from a physiologist who has made many pressure measurements in the vena cava and right atrium with Swans and also with direct lines.
changes are largely equivalent. vena cava may be essentially identical or 1-2 mmHg higher than CVP. Vena Caval pressures might actually be better as they provide a damped or ‘filtered’ signal and less impacted by heart motion and respiratory pressures. Most of the blood volume is in the lower body. On the other hand, central venous pressure’s use for volume status is currently very controversial. In general, it is considered not a sensitive marker of volume in the newer literature, see Marik's publication on "A systematic review of the literature and the tale of seven mares". While the older literature highly touts its value. Your best resource at your institution to discuss this would be an academic anesthesiologist or ICU intensivist. For sure CVP has some value, but I think even the SSC guidelines mentioned this controversy. George George C. Kramer, PhD. Professor Director, Resuscitation Research Lab Dept. of Anesthesiology UTMB, Galveston Office 409-772-3969 Mobile 409-939-3040 Lab -- 409-747-0077 > On Feb 19, 2015, at 9:05 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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