Central Venous Pressure as a Predictor of Fluid Responsiveness: Is This All You Need?
|Marcello Guarnieri, Alessandro Belletti, Francesco Saglietti, and Elena Bignami*|
|Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy|
|*Corresponding Author :||Bignami E
Department of Anesthesia and Intensive Care
IRCCS San Raffaele Scientific Institute
Via Olgettina 60, 20132 Milan, Italy
Tel: +39 02 2643 4524
Fax: +39 02 2643 7178
E-mail: [email protected]
|Rec date: March 08, 2016; Acc date: April 04, 2016; Pub date: April 12, 2016|
|Citation: Guarnieri M, Belletti A,Saglietti F, Bignami E (2016) Central Venous Pressure as a Predictor of Fluid Responsiveness: Is This All You Need?. Gen Med (Los Angeles) 4:228. doi:10.4172/2327-5146.1000228|
|Copyright: © 2016 Guarnieri M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Fluid administration during and after surgery is a fundamental strategy for maintaining hemodynamic stability. Technology offers different strategies for hemodynamic monitoring and decision making about fluids administration. In particular patients may be divided into fluid-responding patients and non-fluid-responding patients. Central venous pressure, measured by a central venous catheter, is a basic measure of right heart preload, and many trials defined it as a non-trustable parameter, with many biases and confounding factors, such as mechanical ventilation and intrathoracic pressure. Nevertheless, many authors describe how a simple value like the Central venous pressure may be useful in hemodynamic monitoring during and after cardiac surgery, although it is not the best available. Moreover the results of a recent survey performed in cardiothoracic intensive care units in Italy, reported how central venous pressure was the easiest and the most frequently used parameter for the monitoring of fluid therapy. Given this state of the art, Central venous pressure seems to be the most criticized but, due to its feasibility and availability, it is still the most used parameter for the evaluation of preload and for the prediction of fluid responsiveness in operating room and Intensive Care Unit.