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Right Atrial Pressure Assessment

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Abstract

Elevations in right atrial pressure (RAP) can cause venous congestion resulting in tissue edema. Ongoing fluid boluses will further elevate RAP leading to organ dysfunction impacting hepatic, bowel, and renal perfusion by inhibiting venous drainage. Increased RAP is difficult to detect clinically, especially in mechanically ventilated patients. Central venous pressure (CVP) and pulmonary artery catheters are affected by mean airway pressure rendering them unreliable. Echo is an exciting alternative. We use evidence of elevated RAP and venous congestion as an indication that fluid is becoming harmful and often limit administration when it is present. How to obtain these measurements is discussed in their respective chapters. In this section, we discuss how to use them together to assess RAP and determine if venous congestion is present.

Keywords

  • Right atrial pressure
  • RAP
  • Central venous pressure
  • CVP
  • Portal venous flow
  • Hepatic venous flow
  • Renal venous flow
  • Acute renal injury

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Abbreviations

CO:

Cardiac output

CVP:

Central venous pressure

D:

Diastole

ECG:

Electrocardiogram

IVC :

Inferior vena cava

MAP:

Mean arterial blood pressure

PASP:

Pulmonary artery systolic pressure

RA :

Right atrial pressure

RAP:

Right atrial pressure

S:

Systolic

SVR:

Systemic vascular resistance

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Correspondence to Sarah B. Murthi .

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Dave, S.B., Murthi, S.B. (2021). Right Atrial Pressure Assessment. In: Salerno, A., Haase, D.J., Murthi, S.B. (eds) Atlas of Critical Care Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-030-74687-2_17

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  • DOI: https://doi.org/10.1007/978-3-030-74687-2_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-74685-8

  • Online ISBN: 978-3-030-74687-2

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