Central venous pressure monitoring.

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.