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Central venous pressure (CVP) alone has so far not found a place in outcome prediction or prediction of fluid responsiveness. Improved understanding of the interaction between mean systemic pressure (Pms) and CVP has major implications for evaluating volume responsiveness, heart performance and potentially patient outcomes.The literature review substantiates that CVP plays a decisive role in causation of operative haemorrhage and renal failure. The review details CVP as a variable integral to cardiovascular control in its dual role of distending the diastolic right ventricle and opposing venous return.The implication for practice is in the regulation of the circulation. It is demonstrated that control of the blood pressure and cardiac output/venous return calls upon regulation of the volume state (Pms), the heart performance (Eh) and the systemic vascular resistance. Knowledge of the CVP is required to calculate all three.