Education  |   May 2019
Central Venous Pressure Waveform Artifact while Transducing a Single Lumen Port
Author Notes
  • From the Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, Massachusetts.
  • Address correspondence to Dr. Cerasuolo: jcerasuolo@tuftsmedicalcenter.org
Article Information
Education / Images in Anesthesiology / Cardiovascular Anesthesia
Education   |   May 2019
Central Venous Pressure Waveform Artifact while Transducing a Single Lumen Port
Anesthesiology 5 2019, Vol.130, 823. doi:10.1097/ALN.0000000000002594
Anesthesiology 5 2019, Vol.130, 823. doi:10.1097/ALN.0000000000002594
Central venous pressure (CVP) monitoring is accurate with multilumen, single-port, and tunneled catheters.1,2  When the ability to use separate lumens for CVP measurement and fluid administration is limited (e.g., only a single functioning lumen), the line may be used for both purposes simultaneously. The image shows an artifact in the CVP waveform appearing as square waves that occur at regular intervals in Panel A. The waveform could be misinterpreted as respirophasic variation, given that it occurs at regular intervals similar to the respiratory rate and end-tidal carbon dioxide waveform. Instead, the CVP tracing was caused by a “continuous” medication pump infusion attached distal to the transducer of a single lumen CVP catheter accessed via a buried port. After stopping the infusion pump, the native CVP tracing is shown in Panel B. To confirm the pump as the culprit of this observation, the pump was then restarted at a different infusion rate (Panel C).