The central venous pressure (CVP) is the most frequently used variable to guide fluid resuscitation in critically ill patients, although its use has been challenged. In this viewpoint, we use a question and answer format to highlight the potential advantages and limitations of using CVP measurements to guide fluid resuscitation.

Volume expansion often ameliorates symptoms of orthostatic intolerance; however, the influence of this increased volume on integrated baroreflex control of vascular sympathetic activity is unknown. We tested whether acute increases in central venous pressure (CVP) diminished subsequent responsiveness of muscle sympathetic nerve activity (MSNA) to rapid changes in arterial pressure. We studied h...

Cardiovascular changes were monitored continuously in 13 women during stimulated labour conducted under extradural analgesia with bupivacaine. Three solutions of bupivacaine (0.5% plain, 0.25% with adrenaline and 0.5% with adrenaline) were administered in a random fashion. The results show that the plain solution of bupivacaine was associated with a decrease in central venous pressure and an in...

highly purified animal insulins.3 Patients should therefore be transferred to human insulin onlv when there is a medical indication, under a doctor's guidance, and after having been informed that a change in symptoms ofhypoglycaemia could occur. As advocated previously,"' a large randomised clinical trial is now needed to establish definitively whether there is an increased risk of severe hypog...

Changes in cardiorespiratory function resulting from haemorrhage and overtransfusion were measured in forty-seven dogs during controlled ventilation. In the animals bled to a mean arterial pressure of 70 mm Hg there were significant reductions in arterial Pco,, carbon dioxide output and oxygen consumption, cardiac output and total venous admixture. In the animals transfused to a mean central ve...

One hypothesized contributor to vision changes experienced by >75% of International Space Station astronauts is elevated intracranial pressure (ICP). While no definitive data yet exist, elevated ICP might be secondary to the microgravity-induced cephalad fluid shift, resulting in venous congestion (overfilling and distension) and inhibition of cerebrospinal and lymphatic fluid drainage from the...

The upright posture strengthens the coupling between heart period (HP) and systolic arterial pressure (SAP) consistently with a greater contribution of the arterial baroreflex to cardiac control, while paradoxically decreasing cardiac baroreflex sensitivity (cBRS). To investigate the physiological mechanisms that mediate the coupling between HP and SAP in response to different postures, we anal...

To assess fluid responsiveness in patients under spontaneous breathing activity ventilation remains a challenge for intensive care physicians. Much of the knowledge on heart-lung interactions and dynamic indexes of fluid responsiveness may not be useful for these patients. Historically, the most frequently used variables to guide fluid responsiveness on this population have been the static prel...