We have not been monitoring CVPs since Process. In general, central lines are placed when there are pressor requirements. Arterial lines are used as needed for "higher" pressor requirements or in patients who have difficulty in obtaining reliable manual BPs on pressors. We are using the Edwards monitors - EV1000 for minimally invasive Flotrac or non-invasive Clearsight in patients who are not quickly responsive or are felt to be more complex to monitor volume responsiveness via stroke volume.
CVP alone is really not considered a reliable measure of fluid responsiveness in septic patients. Marik PE, Monnet X, Teboul J. Hemodynamic parameters to guide fluid therapy. Annals of Intensive Care 2011;1:1. Marik PE, Baram M, Bahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest 2008;134:172-178. Marik P, Bellomo R. A rationale approach to giving fluid in sepsis. British Journal of Anesthesia 2016;116:339-49. Maureen A. Seckel, APRN, ACNS-BC, CCNS, CCRN, FCCM Lead CNS Medical Pulmonary Critical Care Sepsis Coordinator Christiana Care Health System 4755 Ogletown-Stanton Road 3E29 Newark, DE 19718 Office 302 733-6023 [email protected] [cid:[email protected]] From: Sepsisgroups [mailto:[email protected]] On Behalf Of Pender.Linda Sent: Tuesday, August 02, 2016 1:54 PM To: '[email protected]' Subject: [Sepsis Groups] EGDT Is anyone still using EGDT with placing CVP lines and arterial line to monitor fluid status? If so, do you feel this is beneficial? Linda G. Pender RRT-NPS Sepsis Coordinator Patient Care Services Administration phone: 478-633-6806 pager: 4444 KNOW Sepsis: Inside & Out [MCCG...World Class Care! See our website...]<http://www.navicenthealth.org/> Email: [email protected]<mailto:[email protected]> CONFIDENTIALITY NOTICE: The information transmitted in this e-mail message, including any attachments, is for the sole use of the intended recipient(s) or entity to which it is addressed and may contain confidential, privileged, and/or proprietary information. Any unauthorized review, retransmission, use, disclosure, dissemination, or other use of, or taking any action in reliance upon this information by persons or entities other than the intended recipient is prohibited. If you are not the intended recipient, you are hereby notified that any reading, dissemination, distribution, copying, or other use of this message or its attachments is strictly prohibited. If you have received this message in error, please notify the sender immediately by reply e-mail, or by calling (478) 633-7272, and destroy the original message, attachments, and all copies thereof on all computers and in any other form. Thank you. Navicent Health. http://www.navicenthealth.org/
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