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Therapeutics
Systematic review and meta-analysis
Central venous pressure cannot predict fluid-responsiveness
  1. Maurizio Cecconi,
  2. Hollman D Aya
  1. Department of Intensive Care Medicine, St George's Hospital, London, UK
  1. Correspondence to: Dr Maurizio Cecconi, Critical Care, St George's Hospital, Blackshaw Road, London SW170QT, UK; m.cecconi{at}nhs.net

https://doi.org/10.1136/eb-2013-101496

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    Commentary on: Marik PE, Cavallazzi R. Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Crit Care Med 2013;41:1774–81.OpenUrlCrossRefPubMedWeb of Science

    Context

    Central venous pressure (CVP) has been extensively studied in relation to preload and preload responsiveness. In 2008 Marik et al 1 showed the inability of CVP and Δ-CVP to evaluate blood volume status and predict fluid-responsiveness in a systematic review and meta-analysis of 24 studies. In spite of that level of evidence, surviving sepsis campaign guidelines still recommend targeting CVP in order to guide fluid therapy in severe sepsis and septic shock. Interestingly, in Rivers’ study,2 one of the studies referenced to use CVP, the same CVP target values were used in the control as well as …

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    Footnotes

    • Competing interests MC was involved in the consultancy/advisory board/research support, Edwards Lifesciences, LiDCO, Applied Physiology. HDA was involved in the research support, Applied Physiology.