What is the equivalent central venous pressure (CVP) value in cmH2O for an adult septic shock patient with potential cardiovascular comorbidities?

CVP Conversion to cmH₂O

To convert CVP from mmHg to cmH₂O, multiply the mmHg value by 1.36 (or use the approximation that 1 mmHg ≈ 1.36 cmH₂O). 1

Standard Conversion Formula

• 1 mmHg = 1.36 cmH₂O 1
• The American Thoracic Society recommends using mmHg as the standard unit for reporting CVP values, but cmH₂O remains commonly used in clinical practice 1

Practical Examples for Septic Shock Targets

For non-mechanically ventilated septic shock patients:

• Target CVP: 8-12 mmHg 2, 1
• Converted to cmH₂O: 10.9-16.3 cmH₂O 1

For mechanically ventilated septic shock patients or those with decreased ventricular compliance:

• Target CVP: 12-15 mmHg 2, 1
• Converted to cmH₂O: 16.3-20.4 cmH₂O 1

Clinical Context for Septic Shock

The Surviving Sepsis Campaign guidelines specify CVP targets during initial resuscitation of septic shock patients 2:

• Standard target: 8-12 mmHg (10.9-16.3 cmH₂O) for spontaneously breathing patients 2, 1
• Elevated target: 12-15 mmHg (16.3-20.4 cmH₂O) for patients on mechanical ventilation, those with pre-existing decreased ventricular compliance, or increased intra-abdominal pressure >12 mmHg 2, 1

Important Caveats

• Static CVP measurements have limited value in predicting fluid responsiveness, with a positive predictive value of only approximately 50% 1, 3
• CVP should not be used as the sole parameter to guide fluid therapy but rather in conjunction with other clinical parameters including MAP ≥65 mmHg, urine output ≥0.5 mL/kg/h, and central venous oxygen saturation ≥70% 2, 1
• Dynamic measures of fluid responsiveness (passive leg raises, stroke volume variation) demonstrate better diagnostic accuracy than static CVP values 1, 3