Central Venous Pressure and Pulmonary Wedge Pressure in Critical Surgical Illness

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Abstract
To assess the reliability of the central venous pressure (CVP) as an adequate guide to cardiac performance, we inserted a balloon-tipped pulmonary artery catheter (Swan-Ganz 7F, 110 cm) in 27 critically ill surgical patients, and simultaneously measured CVP and pulmonary wedge pressure (PWP). Thirteen patients with a previous history of cardiopulmonary disease showed a poor correlation between CVP and PWP (P>.50). Fourteen patients with no prior history of cardiopulmonary disease showed a significant correlation between CVP and PWP (P<.01). Our findings suggest that the CVP provides a reliable assessment of cardiac function only in the absence of cardiopulmonary disease. Left ventricular failure and pulmonary congestion may be present in these patients even though CVP is normal.

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