Central venous pressure monitoring in critical care settings

Hill, Barry; Smith, C. T.

doi:10.12968/bjon.2021.30.4.230

Cited by 6 publications

(8 citation statements)

References 17 publications

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“…Below, we provide information on the most common methods that may support the selection of the appropriate method in clinical practice. The terms and definitions used in hemodynamic monitoring are summarized in Table II, and a summary of the methods of haemodynamic monitoring is listed in Table I [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

Section: Haemodynamic Monitoringmentioning

confidence: 99%

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Haemodynamic monitoring in acute heart failure – what you need to know

Jasińska-Gniadzik¹,

Szwed²,

Zawadka³

et al. 2022

pwki

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Acute heart failure (AHF) is a sudden, life-threatening condition, defined as a gradual or rapid onset of symptoms and/or signs of HF. AHF requires urgent medical attention, being the most frequent cause of unplanned hospital admission in patients above 65 years of age. AHF is associated with a 4-12% in-hospital mortality rate and a 21-35% 1-year mortality rate post-discharge. Considering the serious prognosis in AHF patients, it is very important to understand the mechanisms and haemodynamic status in an individual AHF patient, thus preventing end-organ failure and death. Haemodynamic monitoring is a serial assessment of cardiovascular function, intended to detect physiologic abnormalities at the earliest stages, determine which interventions could be most effective, and provide the basis for initiating the most appropriate therapy and evaluate its effects. Over the past decades, haemodynamic monitoring techniques have evolved greatly. Nowadays, they range from very invasive to non-invasive, from intermittent to continuous, and in terms of the provided parameters. Invasive techniques contain pulmonary artery catheterization and transpulmonary thermodilution. Minimally invasive techniques include oesophageal Doppler and noncalibrated pulse wave analysis. Non-invasive techniques contain echocardiography, bioimpedance, and bioreactance techniques as well as non-invasive pulse contour methods. Each of these techniques has specific indications and limitations. In this article, we aimed to provide a pathophysiological explanation of the physical terms and parameters used for haemodynamic monitoring in AHF and to summarize the working principles, advantages, and disadvantages of the currently used methods of haemodynamic monitoring.

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Section: Haemodynamic Monitoringmentioning

confidence: 99%

“…CVP is often used as an assessment of haemodynamic status, particularly in the intensive care unit. The normal value of CVP for self-ventilating patients is 0-8 mm Hg [29,30].…”

Section: Central Venous Pressure (Cvp)mentioning

confidence: 99%

Haemodynamic monitoring in acute heart failure – what you need to know

Jasińska-Gniadzik¹,

Szwed²,

Zawadka³

et al. 2022

pwki

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“…A normal central venous pressure reading is between 8 to 12 mmHg. This value is altered by volume status and/or venous compliance [2] .…”

Section: Introductionmentioning

confidence: 99%

Inferior Vena Cava Dispensability Index versus Central Venous Pressure in Volume Status Assessment in Shocked Patients

Abd Alfatah,

Nour –Eldeen,

Diab

2023

International Journal of Medical Arts

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Article informationBackground: The central venous pressure [CVP] remains the most frequently used variable to guide fluid resuscitation in shocked patients and is considered a direct measurement of the blood pressure in the right atrium and vena cava. The ultrasound-guided measurement of the inferior vena cava [IVC] and its changes with respiration has recently been utilized to calculate a patient's fluid status.The Aim of the work: This work aimed to compare ultrasound guided inferior vena cava dispensability index to central venous pressure in shocked patients and to assess the volume status in shocked patients after measurement of CVP and IVC dispensability index [IVC DI]. Patients and Methods:The study was conducted on 60 shocked patients, who were selected from the ICU, Al-Azhar University Hospitals.Results: At cutoff point 7.5 cmH2O, CVP has a sensitivity of 97% and specificity of 96.3% for prediction of hypovolemia. Also, at cutoff point 15.5, IVC-DI has sensitivity of 93.9% and specificity of 100% to predict hypovolemia. In addition, CVP at cutoff point 8.5 cmH2O has sensitivity of 50% and specificity of 55% for predicting fluid responsiveness. Also, at cutoff point 14.5 IVC DI has sensitivity of 100% and specificity of 91.9% for predicting fluid responsiveness. Conclusion:Ultrasound guided CVP and IVC DI were reliable markers in predicting fluid responsiveness and hypovolemia among shocked patients. IVC DI was superior than central CVP.

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“…Today, CVP measurement is a nursing responsibility. Therefore, critical care nurses should be able to measure the CVP competently and identify the factors affecting its readings (Hill and Smith 2021). CVP monitoring is considered one of the significant components of invasive hemodynamic monitoring.…”

Section: Introductionmentioning

confidence: 99%

“…The critical care nurse needs to have an understanding of the functions, benefits, and potential complications of hemodynamic monitoring; as pneumothorax, bleeding, sepsis emboli, and technological advances continue at an ever-increasing rate, nurses must also continue to develop their understanding of the complex data that are subsequently generated (Li, Wang et The close monitoring and observation of critically ill patients is an essential feature of the role of the nurses working in intensive care units. CVP measurement is a nursing responsibility; therefore, the critical care nurse needs to be technically and clinically competent in the CVP measurement (Endla, Kabdal et al 2017, Hill andSmith 2021) Before the CVP measurement, the nurse should assess and observe for signs and symptoms indicating the need for CVP measurement, including low or labile blood pressure, widely diverse intake and output, and fluid administration at a rapid rate. In addition, she should identify the client who is potentially at risk for fluid imbalance and assess the signs and symptoms of fluid volume excess or deficit, requiring CVP measurement to correlate the patient's clinical picture with the CVP value (Magder 2007, Von Rueden 2020 Moreover, critical care nurses should assess all factors that could affect the CVP reading, including the patient's diagnosis, hydration status, administered medications, and obesity.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Impact of a Teaching Program on Nurses' Performance during CVP Measurement in Intensive Care Units: A Quasi-Experimental Study

Abu Jaish

2023

ESJ

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The intensive care unit (ICU) is a specialized area of hospitals dealing with the diagnosis, management, and follow-up of critically ill patients. Moreover, Critical Care Nurses (CCNs) should have strong analytical, interpersonal, and decision-making skills. Objectives: This study aimed to assess the effect of the teaching program on CCNs’ performance during the measurement of central venous pressure (CVP). Design: A quasi-experimental design was used. Methods: The study was conducted in the critical care units at Al-Assad University Hospital, Damascus from June to September 2020. All available registered nurses working in the previous ICUs were included. An observational checklist sheet was developed by the researcher after reviewing the related literature. Each nurse was observed once for each procedure during different shifts. The researcher developed and designed the teaching program based on the nurses’ needs according to their performance during the initial assessment. Results: The results showed that the performance of the nurses improved after the program. The best performance was for nurses in the age group between 20 and 24 years, nurses with a master’s degree, and nurses with less than five years of experience, while the level of knowledge and practice of the studied nurses was average and poor before the teaching program. Overall, this study found a statistically significant relationship before and after the implementation of the program. Conclusion: There has been an obvious improvement in nurses’ knowledge and performance after the teaching program. It is essential to help nurses expand their knowledge and practices to provide high-quality care and promote patient safety.

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Central venous pressure monitoring in critical care settings

Cited by 6 publications

References 17 publications

Haemodynamic monitoring in acute heart failure – what you need to know

Haemodynamic monitoring in acute heart failure – what you need to know

Inferior Vena Cava Dispensability Index versus Central Venous Pressure in Volume Status Assessment in Shocked Patients

Evaluating the Impact of a Teaching Program on Nurses' Performance during CVP Measurement in Intensive Care Units: A Quasi-Experimental Study

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