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Central line placement
The central venous pressure (CVP) is the pressure measured in the central veins close to the heart. It indicates mean right atrial pressure and is frequently used as an estimate of right ventricular preload.
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status.
What is a central venous catheter?
A central venous catheter, also called a central line, is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more.
Normal values are 5-10 mmHg
Factors affecting CVP
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
Indications for the use of central lines include
Monitoring of the central venous pressure (CVP) in acutely ill patients to quantify fluid balance
Long-term Intravenous antibiotics
Long-term Parenteral nutrition especially in chronically ill patients
Long-term pain medications
Chemotherapy
Drugs that are prone to cause phlebitis in peripheral veins (caustic), such as:
Calcium chloride
Chemotherapy
Hypertonic saline
Potassium chloride
Amiodarone
vasopressors (e.g. epinephrine, dopamine)
Plasmapheresis
Peripheral blood stem cell collections
Dialysis
Frequent blood draws
Frequent or persistent requirement for intravenous access
Need for intravenous therapy when peripheral venous access is impossible
Blood
Medication
Rehydration
insertion see video
http://up.top4top.net/d_5fb3815cd31.flv
