Central venous pressure as popular resuscitation surrogate: not totally unjustified.

between CVP and indexes of fluid responsiveness might be influenced by ongoing fluid losses or gains that were not necessarily easily measurable. Finally, in many clinical situations, the success or failure of fluid resuscitation measures is not determined by preset goals in terms of cardiac output or other indexes of cardiac performance but by criteria such as pressor requirements or blood lactate concentrations. While the current recommendations guiding fluid replacement use CVP as only one of a number of clinical parameters to follow,4 and while dynamic parameters may have an increasing role in guiding fluid replacement,5 it may be premature to discard CVP measurements in ICU patients.