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Review
. 2018 Sep 20;8(1):91.
doi: 10.1186/s13613-018-0439-x.

Renal failure in critically ill patients, beware of applying (central venous) pressure on the kidney

Xiukai Chen  1 , Xiaoting Wang  2 , Patrick M Honore  3 , Herbert D Spapen  4 , Dawei Liu  5
Affiliations
Review

Renal failure in critically ill patients, beware of applying (central venous) pressure on the kidney

Xiukai Chen et al. Ann Intensive Care. .

Abstract

The central venous pressure (CVP) is traditionally used as a surrogate of intravascular volume. CVP measurements therefore are often applied at the bedside to guide fluid administration in postoperative and critically ill patients. Pursuing high CVP levels has recently been challenged. A high CVP might impede venous return to the heart and disturb microcirculatory blood flow which may cause tissue congestion and organ failure. By imposing an increased "afterload" on the kidney, an elevated CVP will particularly harm kidney hemodynamics and promote acute kidney injury (AKI) even in the absence of volume overload. Maintaining the lowest possible CVP should become routine to prevent and treat AKI, especially when associated with septic shock, cardiac surgery, mechanical ventilation, and intra-abdominal hypertension.

Keywords: Acute kidney injury; Afterload; Central venous pressure.

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Figures

Fig. 1
Fig. 1
Relationship of all-caused high CVP and AKI. CVP central venous pressure, AKI acute kidney injury
See this image and copyright information in PMC

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