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The determination of the values of central venous pressure has long been used as a guideline for volumetric therapy in the resuscitation of the critical patient, but the performance of such parameter is currently being questioned as an effective measurement of cardiac preload. This has aroused great interest in the search for more accurate parameters to determine cardiac preload and a patient’s blood volume.

Goals and Methodology: Based on literature currently available, we aim to discuss the performance of central venous pressure as an effective parameter to determine cardiac preload.

Results and Conclusion: Estimating variables such as end-diastolic ventricular area and global end-diastolic volume have a better performance than central venous pressure in determining cardiac preload. Despite the best performance of these devices, central venous pressure is still considered in our setting as the most practical and most commonly available way to assess the patient’s preload.

Only dynamic variables such as pulse pressure change are superior in determining an individual’s blood volume.

Manuel Felipe Muñoz Nañez, Universidad del Cauca

Anesthesiologist. Intensive Care Unit, Clínica La Estancia. Universidad del Cauca, Popayán Colombia,
Anesthesiologist. Hospital Universitario del Valle. Colombia,
Ceron Arias, J. S., & Muñoz Nañez, M. F. (2012). Should we stop using the determination of central venous pressure as a way to estimate cardiac preload?. Colombia Medica, 43(2), 181–184.

Pinsky Michael R, Payen Didier. Functional Hemodynamic Mo¬nitoring. Critical Care. 2005;0:566-72

Monnet X, Benoul Jean-Louis. Invasive measures of left ventri¬cular Preload. Curr Opin Crit Care. 2006;12:1235-40

Lopez MR, Auler JOC, Michard F. Volume management in criti¬cally ill patients: new insights. Clinics. 2006; 61(4):345-50.

Goedje O, Seebauer T, Peyerl M, Ulrich JP, Reichart B. He¬modynamic monitoring by double indicator dilution technique in patients after orthotopic heart transplantation. Chest. 2000; 118:775–81

Marino Paul. EL LIBRO DE LA UCI 3 ed, Barcelona. Lippincot Williamns & Wilkins 2007.

Guyton, A.C Hall, J.E. Textbook of Medical Physiology 11th ed.2006 Philadelphia: Elsevier Saunder

Riveros PE. Análisis de materiales y conceptos de ingeniería aplicados a la precarga ventricular izquierda del Corazón huma¬no. Rev Col Anest. 2004; 32:127-30

Kumar A, Anel R, Bunnell E, Habet K, Zanotti S, Marshall S, et al. Pulmonary artery occlusion pressure and central venous pres¬sure fail to predict ventricular filling volume, cardiac performan¬ce, or the response to volume infusion in normal subjects. Crit Care Med. 2004; 32:691–9.

Gelman S. Venous Function and Central Venous Pressure. A 10.Michard F, Teboul JL. Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest. 2002; 121:2000–08.

Marik Paul E, Baram Michael, VahidBobbak. Does Central Ve¬nous Pressure Predict Fluid Responsiveness? A Systematic Review of the Literature and the Tale of Seven Mares. Chest. 2008; 134: 172-78.

Michard F, Alaya S, Zarka V, Bahloul M, Richard C, Teboul JL, et al., Global end-diastolic volume as an indicator of cardiac pre¬load in patients with septic shock. Chest. 2003; 124:1900–08.

Della Rocca G, Costa GM, Coccia C, Pompei L, Di Marco P, Pietropaoli P. Preload index: pulmonary artery occlusion pressure versus intrathoracic blood volume monitoring during lung trans¬plantation. Anesth-Analg. 2002; 95:835–43.

BerkenstadtH, Margalit N, Hadani M, friedman Z, SegalE,Villa Y, et al. Stroke Volume Variation as a Predictor of Fluid Responsi¬veness in Patients Undergoing Brain Surgery. Anesth-Analg. 2001; 92: 984-89.

Preisman S, Kogan S, Berkenstadt H, Perel A. Predicting fluid responsiveness in patients undergoing cardiac surgery: functio¬nal haemodynamic parameters including the Respiratory Systolic Variation Test and static preload indicators. Br J Anaesth. 2005; 95:746–55


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Received 2011-07-08
Accepted 2012-01-30
Published 2012-06-25