A Simple Method for Central Venous Pressure Measurements

FREQUENT measurement of central venous pressure is important in the maintenance of an effective blood volume in seriously ill patients.1The difficulty in placing the tip of a catheter in the intra-thoracic vena cava and the fears of subsequent complications2-4have discouraged the use of this measurement. The procedure described here provides a facile, accurate, and safe measurement of the central venous pressure. Method A polyvinyl-chloride catheter with x-ray markings is placed into the superior vena cava in the following manner. With the patient in a supine, mild scultetus position and the face turned to one side, the external jugular vein becomes prominent when Valsalva's maneuver is performed. Using a local anesthetic, the low point of prominence of the vein is then isolated via a cutdown and a catheter, which is ultimately passed into the superior vena cava, is introduced into the vessel. Occasionally difficulty occurs in passing