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March 1970

Central Venous Pressure: An Unreliable Guide to Fluid Therapy in Bums

Author Affiliations

East Meadow, NY
From the Burn Center Unit, Meadowbrook Hospital, East Meadow, NY.

Arch Surg. 1970;100(3):269-274. doi:10.1001/archsurg.1970.01340210045012

The inaccuracy of blood volume determinations in burn patients using iodinated I 131 serum albumin (RISA-131) is well established. Accordingly, in a quest for a method to dynamically monitor hydration requirements in the acute severe burn, the central venous pressure has assumed an important role.

Publications from many burn centers in the country acclaim the central venous pressure as one of the important parameters to monitor for hydration of the acute, severe burn.1 Urine flow rate measurements have been overshadowed in the current trend towards heavy and sometimes exclusive reliance on the central venous pressure in therapy of the acute burn. Our experience contrasts sharply with the foregoing.

We have found the central venous pressure an unreliable guide to fluid therapy in acute burns.

Methods  Patients with extensive burns fitting Lynch's2 criteria of "critical burn," admitted to the Meadowbrook Hospital Burn Unit, are monitored with indwelling Foley catheters