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CVP and Fluid Responsiveness
- Central venous pressure (CVP) has been used over the last 50 years to assess volume status and fluid responsiveness in critically ill patients.
- Despite widespread practice habit, CVP has not been shown to reliably predict fluid responsiveness in the critically ill.
- In a recent updated meta-analysis, Marik et al reviewed 43 studies, totaling over 1800 patients.
- 57% of patients were fluid responders
- The mean CVP was 8.2 mm Hg for fluid responders and 9.5 mm Hg for non-responders
- For studies performed in ICU patients, the correlation coefficient for CVP and change in cardiac index was just 0.28.
- Bottom line: Current literature does not support the use of CVP as a reliable marker of fluid responsiveness.
References
Marik PE, Cavallazzi R. Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Crit Care Med 2013:41:1774-1781.