Zero reference level

It is important to establish a common reference level from which comparable values of CVP can be determined. In most clinical units, the suprasternal notch, the manubriosternal junction, or the mid-axillary line are used as convenient zero assessment levels. However, radiographic studies have shown that the zero point which corresponds to the entry of caval veins into the right atrium rests on a plane with the fourth intercostal space, 0.43 times the depth of the chest below the anterior surface of the sternum.

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