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.
