Manometry and monitoring

The central venous pressure (CVP) provides an indication of the state of distension of the venous collection system and the relative effectiveness of the pumping action of the heart in emptying the system. Underfilling or overdistension can be recognized by CVP measurements before overt clinical signs have developed. Accordingly, CVP monitoring has been established as an important index to record, for both diagnostic purposes and for assessing the therapeutic effect of volume replacement in critical circulatory problems. The CVP is directly proportional to the venous return and inversely proportional to the myocardial competence or contractility. The venous return is regulated by the blood volume and the capacitance of the venous system and the CVP provides a measure of the effective circulating blood volume relative to the ability of the heart to handle that volume.

It is important to remember, however, that the CVP is not a linear function of blood volume. Isolated CVP readings, unless particularly high, or low, are of little value. Continuous measurement of the CVP with respect to volume expansion or contraction provides a useful guide in intravenous fluid therapy.

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Sleep Apnea

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