Hemodynamically the central venous pressure should be the same in both the supine and lateral positions. The accurate determination of an external zero reference level corresponding with mid right atrial level would make possible reliable measurements in either position. The purpose of this study was to help determine the reliability of two central venous pressure extrathoracic reference points; the midaxillary line as it intersects the fifth intercostal space for a supine position, the fourth intercostal space within the right sternal border for a side-lying position.

Measurements were taken on twenty cadavers during post-mortem examination to determine the relationship of these two reference points to the mid right atrium. Probes were placed in the chest wall at the two reference sites and carefully extended through to the heart. Direct measurements were then taken to determine the distance of the probes from the mid right atrium.

Results of this study revealed that there was a significant difference between the midaxillary reference point and the mid right atrium (p<.001). On an average the midaxillary reference point was 2.9 centimeters posterior to the mid right atrium.

The data of this study suggest there was no significant difference between the sternal reference point and the mid right atrium (p>.05). However, due to the high variability of the data (SD of 2.55 cms.), there is reason to suggest that this is not conclusive and that the sternal reference point might not be a reliable estimate of the zero point for central venous pressure readings in the side-lying position for a large proportion of patients.

LLU Discipline





Graduate School

First Advisor

Dorothy M. Martin

Second Advisor

LaVaun W. Sutton

Third Advisor

Lucile Lewis

Fourth Advisor

Raymond B. Crawford

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Venous Pressure



Page Count

vi; 34

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives

Included in

Nursing Commons