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Central venous pressure (CVP) is the blood pressure in the venae cavae, near the right atrium of the heart.CVP reflects the amount of blood returning to the heart and the ability of the heart to pump the blood back into the arterial system.
A central venous catheter (CVC), also known as a central line (c-line), central venous line, or central venous access catheter, is a catheter placed into a large vein. It is a form of venous access. Placement of larger catheters in more centrally located veins is often needed in critically ill patients, or in those requiring prolonged ...
Catheter placement in one of the big veins (Subclavian vein, Internal jugular vein or femoral vein) is routinely done to monitor central venous pressure (CVP), to administer long term intravenous medication and parenteral nutrition in critically sick patients. The subclavian vein is the preferred choice for this purpose because it is most ...
Justification for its continued use rests on a large body of clinical experience, disadvantages of other cardiac output monitoring systems, its ability to accurately measure pulmonary artery pressure, and the potential to use the catheter as a direct conduit for drug administration into the pulmonary artery.
The doctor can then ask the patient to relax while the back of the examination table is raised to a 30-45˚ angle. From this position, the jugular venous pressure (JVP) can be estimated. Because the right internal jugular vein flows directly into the superior vena cava and then the right atrium, it is a good estimate of central venous pressure.
Additional monitoring which should be immediately available. 1. Blood/capillary glucose 2. Nerve stimulator Additional monitoring which should be available. 1. Urine output 2. Invasive pressure monitoring (arterial line, central venous pressure) 3. Cardiac output monitoring 4. Access to haematological and biochemical investigations
Fluid repletion can be monitored by measuring blood pressure, urine output, mental status, and peripheral edema. Multiple modalities exist for measuring fluid responsiveness such as ultrasound, central venous pressure monitoring, and pulse pressure fluctuation as described above. [4]
Arterial lines are most commonly used in intensive care medicine and anesthesia to monitor blood pressure directly and in real-time (rather than by intermittent and indirect measurement) and to obtain samples for arterial blood gas analysis.