Surviving Sepsis Campaign

CENTRAL VENOUS PRESSURE GOAL

Definition

Studies demonstrating the efficacy of Early Goal Directed Therapy have targeted central venous pressures of between 8-12 mm Hg. For hypotensive patients who have not responded to fluid resuscitation or for those patients with lactate > 4 mmol/L (36 mg/dL), central venous pressure should be maintained 8 to 12 mm Hg in order to reproduce the mortality reductions cited in the literature.

Note: To remain consistent with the literature, no calculation is provided to account for the effects of positive end-expiratory pressure (PEEP) on central venous pressure. Clinicians may wish to make note that central venous pressure as an estimate of volume status will be underestimated in patients receiving PEEP.

Compliance with this bundle element is defined as the percent of patients for whom a CVP goal of > 8 mm Hg was achieved within 6 hours following septic shock or lactate > 4 mmol/L (36 mg/dL) identification.

Numerator	Number of patients with severe sepsis with lactate > 4 mmol/L (36 mg/dL) or septic shock for whom a CVP goal of > 8 mm Hg was achieved within 6 hours of presentation time
Denominator	Number of mechanically ventilated patients presenting with severe sepsis and/or septic shock

Exclusion: Patients with non-severe sepsis or severe sepsis with lactate < 4 mmol/L (36 mg/dL)

Goal

Increase central venous pressure to > 8 mm Hg within 6 hours in 100 percent of indicated cases.

Sample Graph

CVP graph

Use IHI's Improvement Tracker to enter, save, and graph your team's data.