Critical analysis, critical care: central venous pressure monitoring: what's the evidence?

摘要

Consider the following hypothetical clinical situation: a patient in the ICU has indications of hypoperfusion, with low blood pressure and minimal urine output. The patient's central venous pressure (CVP) is 6 mmHg. How would you treat this patient? Would a fluid bolus improve the patient's blood pressure and per-fusion status, or would the administration of a vasopressor be a more appropriate therapy? And what evidence should you use to guide your decision making?