Waves Central



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Definition

CVP is generally measured at the junction of the superior vena cava and the right atrium. This is most commonly this is done via a central venous catheter placed through the right internal jugular vein. A normal CVP waveform contains five components. These components include three peaks (a, c, v) and two descents (x, y). All of these components correspond to various aspects of the cardiac cycle.

The first peak is the a-wave, which immediately follows the p wave of the ECG waveform. The a-wave is a pressure increase that is due to atrial contraction at end-diastole. Shortly after the a-wave there is a second peak , the c-wave. The c-wave immediately follows the r wave of the ECG waveform. This is a pressure increase due to tricuspid bulging into the atrium as a result of isovolumic ventricular contraction (IVC). Note that the a and c-waves are split by the r wave of the ECG waveform. This is because the a-wave always represents end-diastole and the c-wave represents early ventricular systole.

Following the c-wave is the first major descent in the CVP waveform, the x-descent. The x-descent is a drop in atrial pressure during ventricular systole caused by atrial relaxation. At the trough of the x-descent there is an increase in atrial pressure as the atrium begins to fill during late systole. This is called the v-wave. The v-wave corresponds to the end of the t wave in the ECG waveform. The final aspect of the CVP waveform is the y-descent, which is due to an atrial pressure drop as blood enters the ventricle during diastole.

Central Venous Pressure Waveform Components

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See Also:

Sources

  1. Miller’s Anesthesia. 7th ed. / Miller, Ronald D.. Churchill Livingstone, 2009. Chapter 40, Cardiovascuar Monitoring.

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Microsoft has now announced the features available in release wave 2 for its Microsoft Dynamics 365 Business Central. This comprehensive business solution has been designed and optimized for small and midsized organizations. In release wave 2, Microsoft is focusing on improved performance and file storage handling along with deeper integration with Microsoft Teams. The solution is also expanding its geographic footprint, with support for Group Valued Added Tax (VAT).

Release wave 2 highlights include:

  • Upgrades related to performance, reliability and supportability—Microsoft has invested in improving these three essential aspects of service quality. The 2020 release wave 2 includes new accessibility features and updates to service security. Partners can access further telemetry through Azure Insights, resulting in better conflict handling and synchronization with Common Data Service.
  • Productivity—Release wave 2 adds new functionality intended to make end-users more productive, e.g. enhancements to the client as well as the ability to return to the request page after previewing a report and change an assigned printer prior to printing a report.
  • Integration with the Microsoft Power Platform—The Microsoft Power Platform comprises Power BI, Power Apps, Power Virtual Agents, and Power Automate. Each of these elements can enhance the functionality of Dynamics 365 Business Central. Release wave 2 offers new connectors for augmented integration with The Power Platform. It also enables virtual entities.
  • Modern development tools—Dynamics 365 Business Central has moved entirely to Microsoft Visual Studio Code. This makes it possible for developers to be more productive as they write custom code to expand the solution’s functionality for unique use cases.
  • Better together with Microsoft 365—Microsoft Teams now integrates with Dynamics 365 Business Central 2020 release wave 2. Groups of people using Business Central can now collaborate, making faster decisions while accessing business data from Teams channels.
  • Geographic expansion—With 2020 release wave 2 Business Central is now poised to onboard more countries and regions. The plans call for adding Brazil, Ireland and Lithuania.
  • Customer-requested enhancements— Microsoft has added new features, such as email setup, based on customer enhancement requests from the product Ideas portal.
  • Customer migration tools—Microsoft has added functionality that simplifies the migration process for existing Dynamics. Users of Dynamics GP and Dynamics NAV can now more easily make the move to Business Central online. They can selectively migrate Dynamics GP customers and vendors along with Dynamics GP Chart of Account setups.

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Collectively, these 2020 release wave 2 enhancements will drive further service growth by facilitating migration from on-premises versions of Dynamics to Dynamics 365 Business Central. This release will make it easier for companies that rely on Dynamics to take advantage of Business Central’s all-in-one business management solution, with its easy-to-use and easy-to-modify features.

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We work with businesses that are undertaking this migration. As well as, with firms that already have Business Central and want to make optimal use of the solution. To learn more about Dynamics 365 Business Central and what it can do for your business, contact us for a product demonstration.