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Contemporary Reviews in Critical Care Medicine |

Right Atrial Pressure in the Critically Ill: how to measure, what is the value, what are the limitations

Sheldon Magder, MD
Author and Funding Information

The author has no conflicts of interest relevant to this manuscript

Department of Critical Care, McGill University Health Centre, 1001 Decarie Blvd, Montreal, Quebec

S Magder, McGill University Health Centre, Rm D03.6358, 1001 Decarie Blvd, Montreal Quebec.


Copyright 2016, . All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.10.026
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Abstract

Right atrial pressure (Pra) is determined by the interaction of the function of the heart as a pump, called cardiac function, and the factors that determine the return of blood to heart, called return function. Thus, monitoring Pra or its surrogate, central venous pressure (CVP), can give important insights into mechanisms behind changes in hemodynamic status, responses to interventions, and the likelihood of diagnoses. Examination of the components of the Pra tracing, especially during the ventilator cycle, also can give information about right heart diastolic function, status of the tricuspid valve, volume responsiveness and the cardiac rhythm. Importantly, the pressure difference from the large venous reservoir to the heart is small and thus great care must be taken with technical factors that affect the measurement.


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