PubMed · 3848742
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P G Miller. 1985. Assessing C.V.P.. https://doi.org/10.1097/00152193-198509000-00012
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OBJECTIVE: To discuss the rationale, technique, and clinical application of the fluid challenge. DATA SOURCE: Relevant literature from MEDLINE and authors' personal databases. STUDY SELECTION: Studies on fluid challenge in the acutely ill. DATA EXTRACTION: Based largely on clinical experience and assessment of the relevant published literature, we propose that the protocol should include four variables, namely 1) the type of fluid administered, 2) the rate of fluid administration, 3) the critical end points, and 4) the safety limits. CONCLUSIONS: A protocol for routine fluid challenge is proposed with defined rules and based on the patient's response to the volumes infused. The technique allows for prompt correction of fluid deficits yet minimizes the risks of fluid overload. LEARNING OBJECTIVES: On completion of this article, the reader should be able to: 1. Explain the signs of hypovolemia. 2. Describe how to administer a fluid challenge. 3. Use this information in a clinical setting.
PURPOSE OF REVIEW: The proper use of central venous pressure requires a good understanding of basic measurement techniques and features of the waveform. RECENT FINDINGS: If attention is not paid to proper leveling of the transducer and consideration of transmural pressure then major errors are made in the use of central venous pressure. Besides the information gained from the relationship of changes in central venous pressure to changes in cardiac output, there is also much information to be obtained by examining the waveforms of the central venous pressure tracing. Examples are given of rhythm disorders, tricuspid regurgitation, cardiac tamponade, cardiac restriction, and decreased thoracic compliance. SUMMARY: There is much more to the measurement of central venous pressure than the simple digital value on the monitor and the actual waveform should always be examined.