Authors: Coverdale G, Patteril M
Anesthesia & Analgesia ():10.1213/ANE.0000000000007703, August 08, 2025. |
This perspective article examines the evolving role of central venous pressure (CVP) interpretation in perioperative and critical care monitoring. While CVP has historically been used as a surrogate for right atrial pressure and left ventricular preload, guiding fluid therapy with specific targets (e.g., 8–12 mm Hg), recent meta-analyses have questioned its accuracy in predicting fluid responsiveness. International sepsis guidelines no longer recommend CVP for this purpose.
The authors review the decline in CVP-guided therapy following inconsistent results in early goal-directed therapy trials, noting that restrictive fluid strategies and individualized assessments have replaced fixed CVP targets. They emphasize that CVP still provides valuable insights into hemodynamic status when interpreted in context, rather than as an isolated trigger for fluid administration. The article argues that CVP should remain part of the critical care toolkit, but be used alongside other dynamic and patient-specific measurements.
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