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The CVP in hypovolemic shock.

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The CVP in patient with hypovolemic shock
case :
Mostafa 22years old
Agitated and compleaning of abdominal pain
Airway is patent
Respiratory rate 32 per min.
BP 90/60 mmHg.
Pulse 130 bpm.
Temp 36C.
Abdominal distension.
Cold skin
Nsogastric tube rvealed green liqued
Urinary cathetar revealed dark urine
Hemoglobin is 7.
FAST is postive.

Published in: Health & Medicine
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The CVP in hypovolemic shock.

  1. 1. Hwmo Clinical vignette 2 Shock Maryam AL-Qahtani. G:3
  2. 2. Objectives: What would be the central venous and/or pulmonary capillary occlusion pressure (Low, normal, high )?
  3. 3. Hemorrhagic shock is a condition of reduced tissue perfusion, resulting in the inadequate delivery of oxygen and nutrients that are necessary for cellular function.
  4. 4. Central venous pressure Venous pressure: is a term that represents the average blood pressure within the venous compartment. Central venous pressure: considered a direct measurement of the blood pressure in the right atrium and vena cava.
  5. 5. Equation: ΔCVP = ΔV / Cv Normal value : CVP is 2-6 mm Hg. change in volume (ΔV) The compliance (Cv)
  6. 6. Factors influencing the Central Venous Pressure: Cardiac output. Blood volume. Venous constriction. Changing from standing to supine body posture. Arterial dilation.
  7. 7. CVP is elevated by : Heart failure or PA stenosis which limit venous outflow and lead to venous congestion. CVP decreases with: Hypovolemic shock from hemorrhage, fluid shift, dehydration.
  8. 8. Pulmonary capillary occlusion pressure: intravascular pressure as measured by a catheter wedged into the small pulmonary artery ; used to measure indirectly the mean left atrial pressure. Normally about 8-10 mmHg.
  9. 9. In our case : What would be the central venous and/or pulmonary capillary occlusion pressure (Low, normal, high )? Early stage of shock . Compensate stage
  10. 10. The central venous pressure and pulmonary capillary occlusion pressure …… Due to the compensatory mechanism
  11. 11. Initial stage: CVP slightly decrease Blood volume Systemic arterial blood venous return volume pressure pulmonary arteries blood the central venous pressure flow
  12. 12. Compensatory stage: 1/ increasing stroke volume. 2/ increasing the heart rate. 3/raising blood pressure. 4/increasing the rate of return of venous blood to the heart. Vasoconstriction blood vessels + increase blood volume …..>increase arterial pressure. CVP Normal
  13. 13. •Hemorrhage decreases blood volume and decreases CVP (A→B) •By compensatory mechanism (B→C), which increases CVP and shifts blood volume toward heart…..> increase pulmonary capillary occlusion pressure In Short:
  14. 14. The CVP & PCWP in hypovolemic shock differs depend on the stage of the shock. Initial stage  decrease Compensatory stage  normal Uncompensatory stage  decrease
  15. 15. Guyton & Hall. Text book of Medical physiology . .Merck Manual. .Up to data. Website http://www.rnceus.com/hemo/cvp.htm http://www.medscape.com/viewarticle/749208_7 http://cvphysiology.com/Blood%20Pressure/BP020.htm

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