Newly Published
Images in Anesthesiology  |   September 2019
“Arterialization” of the Central Venous Pressure Waveform from a Peripheral Arteriovenous Fistula
Author Notes
  • From the Department of Anesthesiology, Weill Medical College of Cornell University, New York, New York.
  • Competing Interests: The authors declare no competing interests.
    Competing Interests: The authors declare no competing interests.×
  • Correspondence: Address correspondence to Dr. Lichtman: lichtad@med.cornell.edu
Article Information
Images in Anesthesiology / Cardiovascular Anesthesia / Pediatric Anesthesia
Images in Anesthesiology   |   September 2019
“Arterialization” of the Central Venous Pressure Waveform from a Peripheral Arteriovenous Fistula
Anesthesiology Newly Published on September 12, 2019. doi:10.1097/ALN.0000000000002984
Anesthesiology Newly Published on September 12, 2019. doi:10.1097/ALN.0000000000002984
A 65-yr-old male had a history of end-stage renal disease requiring hemodialysis via a left forearm arteriovenous fistula. After placement of a left-sided internal jugular vein catheter, a central venous waveform was noted (see Image).
Patients with renal failure often receive hemodialysis via a surgically created arteriovenous fistula. As the central line is on the ipsilateral side as the fistula “arterialized,” or miniaturized, arterial tracing is produced in the venous waveform. The peak of the central venous pulsations corresponds with the systolic peak of the arterial blood pressure. A dicrotic notch is also noted and corresponds with that of the arterial wave.