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Article
December 18, 1967

CENTRAL VENOUS PRESSURE

JAMA. 1967;202(12):1099. doi:10.1001/jama.1967.03130250081017
Abstract

Central venous pressure determinations, although an extremely valuable tool in assessing the relationship between blood volume, cardiac competence, and vascular tone,1 often is misleading. This has been demonstrated in a recent study of the hemodynamic status of 20 patients with difficult problems of fluid management, as reported in a recent issue of the Archives of Surgery.2

A prime reason for misinterpretation of central venous pressure determinations is the failure to realize that a "family" of ventricular function curves exists, one for each circulatory state. Each curve expresses a constant relationship between ventricular end-diastolic pressure (central venous pressure) and ventricular stroke work. Thus a given increment in venous return in a failing heart will result in a smaller increment in ventricular stroke work than in a normal or supranormal state of myocardial activity. If the myocardium is compromised, a specific central venous pressure will be associated with a smaller

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