To assess the reliability of the central venous pressure (CVP) as an adequate guide to cardiac performance, we inserted a balloon-tipped pulmonary artery catheter (Swan-Ganz 7F, 110 cm) in 27 critically ill surgical patients, and simultaneously measured CVP and pulmonary wedge pressure (PWP). Thirteen patients with a previous history of cardiopulmonary disease showed a poor correlation between CVP and PWP (P>.50). Fourteen patients with no prior history of cardiopulmonary disease showed a significant correlation between CVP and PWP (P<.01). Our findings suggest that the CVP provides a reliable assessment of cardiac function only in the absence of cardiopulmonary disease. Left ventricular failure and pulmonary congestion may be present in these patients even though CVP is normal.
Toussaint GPM, Burgess JH, Hampson LG. Central Venous Pressure and Pulmonary Wedge Pressure in Critical Surgical Illness: A Comparison. Arch Surg. 1974;109(2):265–269. doi:10.1001/archsurg.1974.01360020125024
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