![]() Effects of positional changes on inferior vena caval size and dynamics and correlations with right-sided cardiac pressure. Nephrol Dialysis Transplant Off Publ Eur Dial Transplant Assoc Eur Renal Assoc. Norepinephrine-induced vasoconstriction results in decreased blood volume in dialysis patients. Nette RW, Ie EHY, Vletter WB, Krams R, Weimar W, Zietse R. Ultrasonographic evaluation of ventilatory effect on inferior vena caval configuration. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA. Wang CS, FitzGerald JM, Schulzer M, Mak E, Ayas NT. Clinical assessment of central venous pressure in the critically ill. Estimation of central venous pressure by examination of jugular veins. J Am Soc Echocardiogr Off Publ Am Soc Echocardiogr. Noninvasive evaluation of right atrial pressure. Does this patient have abnormal central venous pressure? JAMA. Evidence-based review of the use of the pulmonary artery catheter: impact data and complications. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. 2005 366:472–7.īinanay C, Califf RM, Hasselblad V, O’Connor CM, Shah MR, Sopko G, Stevenson LW, Francis GS, Leier C, Miller LW. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Harvey S, Harrison DA, Singer M, Ashcroft J, Jones CM, Elbourne D, Brampton W, Williams D, Young D, Rowan K. A one-year prospective study of 141 autopsies. ![]() Catheter-induced lesions of the right side of the heart. Advanced ventricular arrhythmias during bedside pulmonary artery catheterization. Sprung CL, Pozen RG, Rozanski JJ, Pinero JR, Eisler BR, Castellanos A. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. The goal of this review is to summarize the many, often conflicting studies that exist in this area, and provide recommendations for future studies based on our findings. Since the most recent 2015 American Society of Echocardiography guidelines, multiple studies have identified unique ways of improving the accuracy of IVC measurement, which could translate into better CVP estimation. Despite this inconsistency in findings, multiple schemes have been proposed to attempt to estimate CVP from IVC measurements, but when prospectively tested, none has been shown to be accurate. A range of IVC indices including minimum and maximum IVC diameter and fraction of IVC collapse with inspiration (known as collapsibility index) have been studied with highly variable results that range from excellent to poor correlation between these values and CVP. The inferior vena cava (IVC) is a highly compliant vessel that uniquely does not constrict in response to hypovolemia, making it an ideal, noninvasive surrogate for the estimation of CVP. Current noninvasive methods for estimating CVP such as jugular venous pressure assessment are imperfect with wide inter-examiner variability. The gold standard method for assessing CVP is though pulmonary artery catheterization, which is invasive and risks severe complications such as pneumothorax and cardiac conduction abnormalities. Central venous pressure (CVP) is one of only a handful of variables that can be used to assess a patient’s volume status to attempt to optimize stroke volume.
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