Felis ISSN 2398-2950

Central venous pressure

Contributor(s): Elisa Mazzaferro, Elizabeth Rozanski

Introduction

  • Central venous pressure is the pressure measured within the lumen of the cranial vena cava within the thorax, just as it enters the right atrium.
  • The measured value is used to approximate the pressure within the right atrium.
    • It is a measure of right ventricular filling pressure.
    • It is a reflection of intravascular volume, cardiac function and venous compliance.
  • CVP is not interchangeable with pulmonary capillary wedge pressure (PCWP), which is an indicator of left atrial pressure. PCWP can be measured via a catheter (Swan-Ganz) placed into the pulmonary artery and wedged a branch of a pulmonary artery.
  • Specific indications for measurement of CVP include during resuscitation from hypovolemia, during diuresis and in patients with suspected right heart dysfunction.
  • Central venous pressure can be measured in millimeters of mercury (mm Hg) or in centimeters of water (cm H2O). To convert from mm Hg to cm H2O, (mm Hg x 1.36) = cm H2O

Materials and Supplies needed to perform central venous pressure measurement

  • A central venous catheter   Seldinger (over the wire) technique   is placed in the right or left jugular vein.
  • A length of IV extension tubing.
  • Three-way stopcock.
  • Manometer.
  • A 20 ml syringe filled with sterile 0.9% saline solution.

Performing Central Venous Pressure (CVP) Measurements

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The CVP Waveform

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CVP Normal Values

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Use of CVP to guide fluid therapy

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Causes of elevated CVP

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Further Reading

Publications

Refereed papers
  • Waddell L S (2000) Direct blood pressure monitoringClin Tech Sm Anim Pract.15(3), 111-118  PubMed.
  • Machon R G, Raffee M R & Robinson E P (1995) Central venous pressure measurements in the caudal vena cava of sedated catsJ Vet Emerg Crit Care.5(2), 121-129.

Other sources of information

  • Walton R S (2001)Shock. In: Veterinary Emergency Secrets, 2nd edition. Wingfield WE (editor), Hanley and Belfus, Philadelphia, pp. 2836.
  • Abbott J A (2001)Dilated cardiomyopathy. In: Veterinary Emergency Secrets, 2nd edition. Wingfield WE (editor), Hanley and Belfus, Philadelphia, pp 203211.
  • Selavka C M & Rozanski E (2001)Invasive blood pressure monitoring. In: Veterinary Emergency Secrets, 2nd edition. Wingfield WE (editor), Hanley and Belfus, Philadelphia, pp. 469-471.
  • Monnet E (2002) Cardiovascular monitoring.  In: The Veterinary ICU Book. Wingfield WE and Raffee MR, (editors). Teton NewMedia, Jackson Hole, WY, pp. 266-280.


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