Central Line and CVP Flashcards
CVP is not a reliable indicator of
Left ventricular performance
It is a reflection of right atrium pressure, which reflects changes in right ventricular end diastolic pressure
Central venous pressure is anatomically defined as the blood pressure in the
Vena cava at the junction with the right atrium
T or F. If left side preload decreases, CVP will decrease
False. Right side preload
Insertion sites for CVP
Internal jugular (left or right)
Subclavian
Femoral
Brachial
How does one identify between a vein and artery using ultrasound?
The artery will be the one that does not collapse when pressure is applied (obliteration)
What factors can affect the value of CVP?
Cardiac performance Blood volume Vascular tone Increased intraabdominal or intrathoracic pressures Vasopressor therapy
The A wave (atrial contraction) occurs right after
P wave on EKG
The A wave is increased by
Tricuspid stenosis RVH Pulm stenosis Pulm HTN Giant A waves cannon
The C wave is caused by the elevation of _________ into the right atrium during early ventricular/systolic contraction
Tricuspid valve
The C wave corresponds to what part of the EKG?
The end of QRS
Atrial relaxation and downward displacement of the tricuspid valve during ventricular systole is represented by
The X descent
What part of the EKG correlates to the X descent?
Before the T wave
Caused by pressure produced when the blood filling the right atrium hits against a closed tricuspid valve
The V wave
The V wave corresponds to what part of the EKG?
The end of the T wave
During tricuspid regurgitation, this wave will be very prominent
V
The Y descent is produced by blood flowing into
The right ventricle through an open tricuspid valve
The y descent correlates with what part on an EKG?
Occurs before the P wave (prior to atrial contraction)
Indications for CVP
Monitor preload, hypovolemia, shock, aspiration of air emboli, TPN, insertion of transcutaneous pacing leads, IV access in patients with poor peripheral veins, infusions of vasoactive meds
Contraindications to CVP
Tumors in the right atrium
Severe coagulopathy
Ipsilateral carotid endarterectomy
Complications of CVP placement
Pneumothorax, carotid artery puncture, he thorax from vascular puncture, air embolism, wire embolization, thrombosis, cardiac perforation, hematoma, cardiac tamponade, arrhythmias, hydrothorax, chylothorax, infection
What are normal CVP values… According to the notes?
10-12 mmHg
