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Central Venous Pressure

Powerpoint Presentation about Central Venous Pressures and the disease conditions related to Central Venous Pressure when it increases or decreases.

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Angelo Arquiza
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995 views10 pages

Central Venous Pressure

Powerpoint Presentation about Central Venous Pressures and the disease conditions related to Central Venous Pressure when it increases or decreases.

Uploaded by

Angelo Arquiza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Angelo Arquiza

BSN IIIA

CENTRAL VENOUS
PRESSURE

What is Central Venous


Pressure

The central venous pressure (CVP) is the pressure


measured in the central veins close to the heart. It
indicates mean right atrial pressure and is frequently
used as an estimate of right ventricular preload. The
CVP does not measure blood volume directly,
although it is often used to estimate this. In reality the
CVP value is determined by the pressure of venous
blood in the vena cava and by the function of the
right heart, and it is therefore influenced not only by
intravascular volume and venous return, but also by
venous tone and intrathoracic pressure, along with
right heart function and myocardial compliance.

When should CVP be measured?

Patients with hypotension who are not


responding to basic clinical
management.
Continuing hypovolaemia secondary to
major fluid shifts or loss.
Patients requiring infusions of inotropes.

How to measure the CVP ?

The CVP can be measured either manually using a


manometer or electronically using a transducer. In
either case the CVP must be zeroed at the level
of the right atrium. This is usually taken to be the
level of the 4th intercostal space in the mid-axillary
line while the patient is lying supine. Each
measurement of CVP should be taken at this same
zero position. Trends in the serial measurement of
CVP are much more informative than single
readings. However if the CVP is measured at a
different level each time then this renders the trend
in measurement inaccurate.

1. Using the manometer


A 3-way tap is used to connect the manometer to an intravenous drip set on one side, and, via
extension tubing filled with intravenous fluid, to the patient on the other (Diagram 1). It is
important to ensure that there are no air bubbles in the tubing, to avoid administering an air
embolus to the patient. You should also check that the CVP catheter tubing is not kinked or
blocked, that intravenous fluid can easily be flushed in and that blood can easily be aspirated
from the line. The 3-way tap is then turned so that it is open to the fluid bag and the manometer
but closed to the patient, allowing the manometer column to fill with fluid (Diagram 2). It is
important not to overfill the manometer, so preventing the cotton wool bung at the manometer
tip from getting wet. Once the manometer has filled adequately the 3-way tap is turned again
this time so it is open to the patient and the manometer, but closed to the fluid bag (Diagram 3).
The fluid level within the manometer column will fall to the level of the CVP, the value of which
can be read on the manometer scale which is marked in centimetres, therefore giving a value
for the CVP in centimetres of water (cmH2O). The fluid level will continue to rise and fall slightly
with respiration and the average reading should be recorded.

2. Using the transducer


The transducer is fixed at the level of the right atrium and connected to the patient's CVP
catheter via fluid filled extension tubing. Similar care should be taken to avoid bubbles and
kinks etc as mentioned above. The transducer is then 'zeroed' to atmospheric pressure by
turning its 3-way tap so that it is open to the transducer and to room air, but closed to the
patient. The 3-way tap is then turned so that it is now closed to room air and open between the
patient and the transducer. A continuous CVP reading, measured in mmHg rather than cmH2O,
can be obtained. (Diagram 4)

Diagram 1

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text.

Diagram 2

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text.

Diagram 3

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text.

Diagram 4

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text.

Thank you for listening!!!!

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