WordNet

the force applied to a unit area of surface; measured in pascals (SI unit) or in dynes (cgs unit); "the compressed gas exerts an increased pressure" (同)pressure level, force per unit area
an oppressive condition of physical or mental or social or economic distress
the somatic sensation that results from applying force to an area of skin; "the sensitivity of his skin to pressure and temperature was normal" (同)pressure_sensation
a force that compels; "the public brought pressure to bear on the government"
in or near a center or constituting a center; the inner area; "a central position"
a workplace that serves as a telecommunications facility where lines from telephones can be connected together to permit communication (同)telephone exchange, exchange
of or contained in or performing the function of the veins; "venous inflammation"; "venous blood as contrasted with arterial blood"; "venous circulation"

PrepTutorEJDIC

〈U〉『押すこと』,『押しつけること』,圧搾,圧縮;〈C〉〈U〉『圧力』,圧力の強さ / 〈U〉『圧迫』,『強制』 / 〈U〉(不快な)圧迫感 / 〈C〉〈U〉(精神的な)重荷,苦脳;(時間・金銭的)切迫 / 〈U〉多忙,あわただしさ / 《おもに米》…‘に'圧力をかける,強制する(《英》pressurise)
『中心の』,中央の,中心からの / 『主要な』,中心的な(main) / (音声が)中舌音の / 電話交換局(《英》[telephone]exchange)
静脈[血]の / 葉脈の多い

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/22 04:25:58」(JST)

wiki en

Central venous pressure (CVP) (also known as: right atrial pressure; RAP) describes the pressure of blood in the thoracic vena cava, near the right atrium of the heart. CVP reflects the amount of blood returning to the heart and the ability of the heart to pump the blood into the arterial system.

It is a good approximation of right atrial pressure,^[1] which is a major determinant of right ventricular end diastolic volume. CVP has been, and often still is, used as a surrogate for preload, and changes in CVP in response to infusions of intravenous fluid have been used to predict volume-responsiveness (i.e. whether more fluid will improve cardiac output). However, there is increasing evidence that CVP, whether as an absolute value or in terms of changes in response to fluid, does not correlate with ventricular volume (i.e. preload) or volume-responsiveness, and so should not be used to guide intravenous fluid therapy.^[2]^[3] Nevertheless, CVP monitoring is a useful tool to guide hemodynamic therapy.

Measurement[edit]

Site		Normal pressure range (in mmHg)^[4]
Central venous pressure		3–8
Right ventricular pressure	systolic	15–30
Right ventricular pressure	diastolic	3–8
Pulmonary artery pressure	systolic	15–30
Pulmonary artery pressure	diastolic	4–12
Pulmonary vein/ Pulmonary capillary wedge pressure		2–15
Left ventricular pressure	systolic	100–140
Left ventricular pressure	diastolic	3-12

Normal CVP can be measured from two points of reference:

Sternum: 0–14 cm H₂O
Midaxillary line: 8–15 cm H₂O

CVP can be measured by connecting the patient's central venous catheter to a special infusion set which is connected to a small diameter water column. If the water column is calibrated properly the height of the column indicates the CVP.

In most intensive care units, facilities are available to measure CVP continuously.

Normal values are 5-10 cmH20 ^[5]

Factors affecting CVP[edit]

Factors that increase CVP include:

Hypervolemia
forced exhalation
Tension pneumothorax
Heart failure
Pleural effusion
Decreased cardiac output
Cardiac tamponade
Mechanical ventilation and the application of positive end-expiratory pressure (PEEP)
Pulmonary Hypertension
Pulmonary Embolism

Factors that decrease CVP include:

Hypovolemia
Deep inhalation
Distributive shock

References[edit]

^ "Central Venous Catheter Physiology". Retrieved 2009-02-27.
^ Kumar A, Anel R, Bunnell E, Habet K, Zanotti S, Marshall S et al. (2004). "Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects". Crit Care Med 32 (3).
^ Marik P, Baram M, Vahid B (July 2008). "Does Central Venous Pressure Predict Fluid Responsiveness?". Chest 134 (1).
^ Table 30-1 in: Trudie A Goers; Washington University School of Medicine Department of Surgery; Klingensmith, Mary E; Li Ern Chen; Sean C Glasgow (2008). The Washington manual of surgery. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 0-7817-7447-0.
^ Egan's Fundamentals of Respiratory Care 9th ed, p. 1140

External links[edit]

Venous function and central venous pressure: a physiologic story - a technical discussion of the more modern understanding of central venous pressure; this may well conflict with the sources below.
Central Venous Pressure Monitoring
Cardiovascular Physiology Concepts
Central Venous Pressure and Pulmonary Capillary Wedge Monitoring
Cardiovascular Physiology
Central Venous Pressure at the US National Library of Medicine Medical Subject Headings (MeSH)

This medical article is a stub. You can help Wikipedia by expanding it.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 頚静脈波の検討 examination of the jugular venous pulse
2. 成人における体液量減少の病因、臨床症状、および診断 etiology clinical manifestations and diagnosis of volume depletion in adults
3. 成人における確定診断を得られていない低血圧やショックの評価および初期アプローチ evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock
4. 中心静脈アクセスの概要 overview of central venous access
5. 成人における浮腫の臨床症状および診断 clinical manifestations and diagnosis of edema in adults

English Journal

Optimized fluid management improves outcomes of pediatric burn patients.

Kraft R, Herndon DN, Branski LK, Finnerty CC, Leonard KR, Jeschke MG.SourceShriners Hospitals for Children, Galveston, Texas; Department of Surgery, University Texas Medical Branch, Galveston, Texas.
The Journal of surgical research.J Surg Res.2013 May 1;181(1):121-8. doi: 10.1016/j.jss.2012.05.058. Epub 2012 Jun 6.
BACKGROUND: One of the major determinants for survival of severely burned patients is appropriate fluid resuscitation. At present, fluid resuscitation is calculated based on body weight or body surface area, burn size, and urinary output. However, recent evidence suggests that fluid calculation is i
PMID 22703982

Plasma drug concentrations and clinical effects of a peripheral alpha-2-adrenoceptor antagonist, MK-467, in horses sedated with detomidine.

Vainionpää MH, Raekallio MR, Pakkanen SA, Ranta-Panula V, Rinne VM, Scheinin M, Vainio OM.SourceDepartment of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
Veterinary anaesthesia and analgesia.Vet Anaesth Analg.2013 May;40(3):257-64. doi: 10.1111/vaa.12012. Epub 2013 Jan 31.
OBJECTIVE: To investigate plasma drug concentrations and the effect of MK-467 (L-659'066) on sedation, heart rate and gut motility in horses sedated with intravenous (IV) detomidine.STUDY DESIGN: Experimental randomized blinded crossover study.ANIMALS: Six healthy horses.METHODS: Detomidine (10 μg
PMID 23368795

Japanese Journal

Acute Kidney Injury after Hepatic Surgery with Goal Directed Fluid Therapy

Sakamoto Miki,Kobayashi Yuki,Tanigawa Saori,Miyakawa Hidetoshi,Otsubo Takehito,Tateda Takeshi
Journal of St. Marianna University 6(1), 47-54, 2015
… Central venous pressure (CVP) and stroke volume variation (SVV) were monitored continuously by arterial contour analysis using a FloTrack sensorTM (Edwards life sciences LLC, CA, USA) for restrictive fluid management during portal triad clamping (PTC) with inferior vena cava (IVC) clamping. …
NAID 130005085594

Influence of pneumoperitoneum and postural change on the cardiovascular and respiratory systems in dogs

PARK Young Tae,OKANO Shozo
Journal of Veterinary Medical Science advpub(0), 2015
… PP with CO2 (intraperitoneal pressure 15 mmHg) and a postural change (15 degrees) was performed during the experiment. … As parameters of circulatory kinetics, heart rate (HR), mean aortic pressure (MAP), mean pulmonary arterial pressure (MPAP), central venous pressure (CVP), femoral venous pressure (FVP), and cardiac output (CO) were measured. …
NAID 130005071897

Efficacy of Pulmonary Vasodilator Therapy in Patients With Functionally Single Ventricle

Park In-Sam
International Heart Journal 56(Supplement), S26-S30, 2015
… The reasons for vasodilator treatment included high pulmonary artery pressure or pulmonary vascular resistance (n = 8), high central venous pressure after the Fontan or bidirectional Glenn procedure (n = 7), and ventilatory impairment (n = 8). …
NAID 130004941330