Nitroglycerin increases venous return but reduces CVP: a preload paradox?

Background and goal of study
The difference between the mean systemic filling pressure (Pms) and central venous pressure (CVP) is the pressure gradient of venous return (VR). The Navigator software (Applied Physiology, Sydney, Australia) provides an estimation for Pms and may therefore to assess the pressure gradient for VR1.
Although nitroglycerin (NTG) always lowers CVP, its effect on cardiac output (CO) and VR will vary in function of the cardiovascular status.
The goal of this study is to assess the hemodynamic effect of NTG in coronary artery bypass (CABG) patients by calculating Pms and heart performance Eh with the use the Navigator software in addition to standard hemodynamic monitoring.

Parkin and Leaning. Therapeutic control of the circulation. J Clin Monit Comput (2008) vol. 22 (6) pp. 391-400

  • Investigators UZ Gent : Dr. S. Bouchez, Prof. Dr. S. De Hert
  • Study : Observational monocentric prospective study in coronary artery bypass patients.