American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the target central venous pressure (CVP) for fluid management in certain patients?

1. 10 mm Hg

2. 6 mm Hg or less

3. 4 mm Hg or less

4. 8 mm Hg or less

The correct answer is: 4 mm Hg or less

In the context of fluid management, particularly in critically ill patients, recognizing the appropriate target central venous pressure (CVP) is crucial for ensuring adequate fluid resuscitation while preventing fluid overload. The correct target of 4 mm Hg or less is based on the understanding that lower CVP values can indicate more effective intravascular volume status and responsiveness to fluids, especially in scenarios like sepsis or hypovolemic shock. Aiming for this target can help clinicians avoid the complications associated with elevated CVP levels, which may indicate fluid overload, heart failure, or unnecessary strain on the cardiovascular system. Furthermore, evidence suggests that aiming for lower CVP can be beneficial in improving outcomes by allowing for better management of volume status and guiding further interventions. The other options present values that suggest higher CVP targets, which may not align with modern practices in managing certain patient populations effectively.