Abstract
Bedside measurement of pulmonary artery pressure and pulmonary artery wedge pressure has an important role in the management of critically ill patients. Unfortunately, waveform abnormalities and artifacts commonly distort numeric values and lead to incorrect therapeutic decisions. The clinical impact of these artifacts is magnified by the digital pressure displays used in most intensive care units. We present here an atlas and an analysis of the artifacts that commonly occur. Use of analog rather than digital pulmonary artery wedge pressure data, when combined with an understanding of the physiological characteristics of patients, can prevent critical errors in patient management.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Swan HJC, Ganz W, Forrester J, et al: Cardiac catheterization with a flow directed, balloon tipped catheter. N Engl J Med 1970;283:447–451
Ellis DM: Interpretation of beat-to-beat blood pressure values in the presence of ventilatory changes. J Clin Monit 1985;1:65–70
Pepe PE, Marini JJ: Occult positive end-expiratory pressure in mechanically ventilated patients with airflow obstruction. Am Rev Respir Dis 1982;126:166–170
McGregor M: Pulsus paradoxus. N Engl J Med 1979;301:480–482
Rice DL, Awe RJ, Gaaseh WH, et al: Wedge pressure measurement in obstructive pulmonary disease. Chest 1974;66:628–632
Permutt S: Relation between pulmonary arterial pressure and pleural pressure during the acute asthmatic attack. Chest 1973;63:25S-28S
Berryhill RE, Benumot JL, Rauscher LA: Pulmonary vascular pressure reading at the end of exhalation. Anesthesiology 1978;49:365–368
Davison D, Parker M, Harrison RA: The validity of determination of pulmonary wedge pressure during mechanical ventilation. Chest 1978;73:352–355
Schuster DP, Seeman MD: Temporary muscle paralysis for accurate measurement of pulmonary artery occlusion pressure. Chest 1983;84:593–597
Maran AG: Variables in pulmonary capillary wedge pressure: Variation with intrathoracic pressure, graphic and digital recorders. Crit Care Med 1980;8:102–105
Quinn KQ, Quebbeman EJ: Pulmonary artery pressure monitoring in the surgical intensive care unit. Arch Surg 1981;116:872–876
Cengiz M, Crapo RO, Gardner RM: The effect of ventilation on the accuracy of pulmonary artery and wedge pressure measurements. Crit Care Med 1983;11:502–507
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schmitt, E.A., Brantigan, C.O. Common artifacts of pulmonary artery and pulmonary artery wedge pressures: Recognition and interpretation. J Clin Monitor Comput 2, 44–52 (1986). https://doi.org/10.1007/BF01619176
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01619176