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Central Venous Monitoring 2022

Central venous pressure (CVP) reflects the amount of blood returning to the heart and its ability to pump blood. CVP monitoring is done continuously or intermittently via a central line to estimate cardiac function, venous return, and right ventricular function. Normal CVP ranges from 4-10 cmH2O; increased values can indicate issues like fluid overload, while decreased values may signal hypovolemia or shock. Proper procedure and zero referencing are important for accurate CVP readings.

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140 views17 pages

Central Venous Monitoring 2022

Central venous pressure (CVP) reflects the amount of blood returning to the heart and its ability to pump blood. CVP monitoring is done continuously or intermittently via a central line to estimate cardiac function, venous return, and right ventricular function. Normal CVP ranges from 4-10 cmH2O; increased values can indicate issues like fluid overload, while decreased values may signal hypovolemia or shock. Proper procedure and zero referencing are important for accurate CVP readings.

Uploaded by

Angie
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Central Venous

Monitoring
Carlo Cabardo, RN, MAN
Central venous pressure (CVP)
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.
CVP monitoring is performed
in critical and acute care
settings and can be done
either continuously or
intermittently via a central
line.
It is used to estimate a patient’s
cardiac function, venous return
to the heart, and gauge how well
the right ventricle of the heart is
functioning…if the heart cant
accept blood, then it will back up
into the venous system affecting
the intravascular fluid volume
status.
The central venous catheter
(CVC) also facilitates access to
a large vessel which allows for
rapid, high volume fluid
administration and frequent
blood draws.
Increase:
What ▪Fluid overload
▪Right heart failure
do CVP ▪Cardiac tamponade
▪Pleural effusion
values ▪Tension pneumothorax
mean? ▪Forced exhalation
▪Mechanical ventilation
What Decrease:

do CVP ▪Hypovolemia

values ▪Shock

mean? ▪Forced inhalation


COMPLICATIONS
Arterial puncture
Pneumothorax
Cardiac dysrhythmias
Air embolism
Infection
Hemorrhage
Catheter Displacement
THE PROCEDURE
1. Check doctor’s order in the client’s chart
2. Gather materials
 Venous pressure tray
 Cut-down tray
 Infusion solution and infusion set
 3-way or 4-way stopcock (a pressure transducer
may also be used)
 IV pole attached to bed
 Arms board
 Adhesive tape
 ECG monitor
 Carpenter’s level (for establishing zero point)
1. Wash hands
2. Put on gloves
5. Attach manometer to the IV Pole
6. Prime the manometer tubing and the
three way tap
7. Place the patient in a supine position
NOTE: Each time client changes
position, positioning of manometer
will need to be readjusted to zero
reference point.
5. Find and mark the right atrium. Locate the
Phlebostatic Axis:

This is where the fourth intercostal space and mid-axillary line


cross each other allowing the measurement to be as close to the
right atrium as possible.
The phlebostatic axis is defined as
the intersection of 2 reference lines:
1. an imaginary line from the fourth
intercostal space at the point where
the space joins the sternum, drawn
out to the side of the body
2. a line drawn midway between the
anterior and posterior surfaces of the
chest.
9. Place the “0” (zero) point of the CVP
monitor on the same level as the
client’s right atrium or where the “X”
mark is.
10.Open the stopcock to fill the CVP
monitor with an IV Fluid (20-25 cm
level). Do not fill to the top, about 2/3
full is ample for measurement.
NOTE: IV solution to manometer open,
patient close.
11.Turn the stopcock to the venous
opening (flows in to the client)
NOTE: Manometer to patient open,
IV solution close.
12.Observe the fluid fluctuating
with each respiration.
13.Allow the fluid to stabilize before
taking a reading.
NORMAL RANGE: 4-10
cmH2O
14.When the procedure is finished, turn the
stopcock to allow the fluid to flow normally.
NOTE: IV solution to patient is open,
manometer is close.
15.Adjust IV to desired rate.
16.Ensure client’s safety and comfort. Place the
client in supine position or in the same
position before reading.
15.Remove and disclose gloves.
16.Wash hands
17.Document the result indicating the
appearance of the dressing, tubing and
solution changes. Include the client’s
tolerance to procedure and the date
and time of the reading.
CVP reading taken from left subclavian triple lumen
catheter, see flow sheet. No redness or swelling noted at the
insertion site, dressing is clean, dry, and intact. IV fluids of
PNSLS L x 20cc/h continue to infuse, as ordered.

Carlo Cabardo, RN, MAN

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