Felix A. Hughes

Central venous pressure monitoring: A useful aid in the management of shock☆

Abstract Monitoring of the central venous pressure is a relatively simple clinical procedure. It is invaluable in assessing promptly the hemodynamic abnormality causing the state of shock and its rapid correction. The level of the central venous pressure at any single measurement is often less significant than the response of the central venous pressure to rapid trial infusions. In general, patients in shock with low central venous pressures have either a volume deficit or, rarely, peripheral pooling. Suitable volume expanding fluids may be administered rapidly and safely. If the central venous pressure and blood pressure are restored to normal, a volume deficit existed. If repeated infusions fail to restore the blood pressure and central venous pressure, pooling in the periphery due to vascular failure must be concluded. Elevated or rising central venous pressure indicates myocardial insufficiency, and further infusions should be curtailed with efforts then directed toward improving myocardial function.

Blastomycosis of the lung

Abstract A report of a patient with blastomycosis of the lung treated with lobectomy is presented. The result thus far appears to be favorable.