Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Pulmonary Wedge Pressure”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1978

Pulmonary abnormalities in mitral valve disease. Comparison between pulmonary wedge pressure, regional pulmonary blood flow and chest films.

Chest films, right sided heart catheterization, and measurement of the regional lung perfusion, using 133Xe, were carried out 31 times on patients with mitral valve disease. A relationship was found between the radiologic evaluation in 3 grades, and the values of pulmonary wedge pressure and the apical and basal perfusion. Changes in flow distribution as reflected in altered appearance of the vessels and the presence of interstitial edema were found to be the most sensitive factors in the evaluation of pulmonary wedge pressure. Chest radiography was thus found suitable for the evaluation of pulmonary wedge pressure in mitral valve disease.

Adult↗
PubMed2001

Pulmonary wedge pressures confirm pulmonary hypertension in broilers is initiated by an excessive pulmonary arterial (precapillary) resistance.

High retrograde pressure through the pulmonary venous system caused by failure of the left ventricle or left atrio-ventricular valve may result in the elevated pulmonary arterial pressure and right ventricular hypertrophy associated with pulmonary hypertension syndrome (PHS; ascites) in broiler chickens. In the present study, unanaesthetized male broilers from an ascites-resistant line, the base population from which the resistant line was derived, and a separate unselected line were used to determine whether changes in wedge pressure (thought to be similar to left atrial pressure) are predictive of differences in the pulmonary arterial pressure of clinically healthy and pre-ascitic broilers. Venous, right atrial, right ventricular, pulmonary arterial, and wedge pressures were obtained by inserting a catheter into a wing vein and progressively advancing the catheter into a pulmonary branch artery until the catheter tip became wedged in and occluded the flow through a terminal artery. Mean right ventricular and pulmonary arterial pressures were lower in the resistant line than in the base population, but wedge pressures did not differ between the resistant, base, and unselected lines. Right:total ventricular weight ratios (RV:TV) and the percentage saturation of hemoglobin with oxygen in arterial blood ranged in value from 0.18 to 0.44 and 65 to 96%, respectively. Wedge pressure, however, remained similar when pre-ascitic broilers with high RV:TV values and low oximetry values were compared with clinically healthy broilers. In all birds, whether healthy or showing pre-ascitic characteristics, the wedge pressure was slightly higher than the right atrial pressure but substantially lower than pulmonary arterial pressure. These observations provide definitive proof that pulmonary hypertension is initiated as a consequence of excessive pulmonary arterial or arteriole resistance. Pulmonary venous pressure is estimated by measuring the pulmonary arterial wedge pressure, and high wedge pressures would be evident if pulmonary hypertension was caused by the elevated downstream resistances associated with left-sided heart failure.

Animals↗
PubMed1984

Wedge pulmonary angiography to determine the accuracy of pulmonary wedge pressure.

Wedge pulmonary angiography was done in 11 patients with acute respiratory failure, to assess the accuracy of pulmonary arterial wedge pressure (WP) as an estimation of left ventricular end-diastolic pressure (LVEDP). The pulmonary artery (PA) catheter tip was placed into a dependent position in the lungs. Although the pulmonary vein was not visualized in 7 of 11 patients, in no case was there a significant difference between WP and LVEDP. When WP is no greater than 15 mm Hg, wedge pulmonary angiography does not reflect the accuracy of WP; however, left ventricular filling pressure can be accurately estimated by WP in most of these patients.

Acute Disease↗
PubMed1976

Central venous pressure and pulmonary wedge pressure. A comparative study in anesthetized surgical patients.

To determine the reliability of central venous pressure (CVP) as a guide to fluid therapy during an operation, repeated and simultaneous CVP and pulmonary wedge pressure (PWP) measurements were made with a Swan-Ganz catheter in 13 relatively elderly patients without obvious cardiac or respiratory disease- Overall correlation between CVP and PWP was highly significant (P less than .001); there was, however, an important variation of the correlation for each patient. For values of CVP greater than or equal to 8 mm Hg, the correlation was not significant. The disparity between right and left ventricular filling pressures was confirmed by the relationship between serial changes in CVP and PWP. These data strongly suggest that in relatively elderly patients undergoing surgery without evidence of cardiac or respiratory disease, CVP may be misleading index for appreciating PWP.

Aged↗
PubMed2000

Prediction of mean pulmonary wedge pressure using doppler pulmonary venous flow variables in hypertrophic cardiomyopathy.

We examined whether pulmonary venous flow variables, assessed by transthoracic Doppler echocardiography, could predict mean pulmonary wedge pressure in hypertrophic cardiomyopathy. Forty-four patients with no left ventricular systolic dysfunction (left ventricular fractional shortening > or =25%) were studied. Forty patients with systolic dysfunction (dilated cardiomyopathy group) served as control. Mitral and pulmonary venous flow velocity curves were recorded with the pulsed-Doppler method and were related to mean pulmonary wedge pressure obtained by right heart catheterization. In hypertrophic cardiomyopathy group, the systolic (r=-0.15, P=0.335) and diastolic (r=0.35, P=0.022) forward flow velocity were poorly related to mean pulmonary wedge pressure, whereas the velocity of atrial reversal (r=0.68, P<0.001) correlated well with mean pulmonary wedge pressure. In dilated cardiomyopathy group, the systolic (r=-0.51, P=0.001) and diastolic (r=0.60, P<0.001) forward flow velocity were strongly related to mean pulmonary wedge pressure. With the cut-off value set at the velocity of atrial reversal >30 cm/s in hypertrophic cardiomyopathy group, the sensitivity for predicting mean pulmonary wedge pressure >15 mmHg was 79% and the specificity was 73%. In conclusion, the atrial component of the pulmonary venous flow can be used to predict mean pulmonary wedge pressure in hypertrophic cardiomyopathy.

Adult↗
PubMedDate not supplied

Artifacts in the measurement of pulmonary artery wedge pressure.

Pulmonary artery wedge pressure (PAWP) will only reflect left atrial pressure (LAP) if continuity of fluid exists from the catheter tip to the left atrium. Either increased airway pressure or decreased hydrostatic pressure may lead to discontinuity of the fluid column and midinterpretation of PAWP. Simultaneous measurements of PAWP and LAP were made in 19 anesthetized dogs. Placement of the pulmonary artery wedge catheter above the left atrium (West Zone I) in combination with the incremental addition of 5 cm H2O of PEEP caused a 5 mm Hg gradient between PAWP and LAP in the normovolemic animal. Augmenting PEEP further or hypovolemia (i.e., decrease in LAP) increased the gradient. Hypervolemia (increase in LAP) diminished the gradient. Fluid continuity between the PAW catheter and LA is a prerequisite for monitoring LAP with the Swan-Ganz catheter. Increases in PEEP, placement of the catheter above the left atrium and hypovolemia may occlude the fluid column and cause artifacts in the PAWP obtained.

Blood Pressure↗
PubMed2002

Restrictive left ventricular filling and preserved ventricular function: a limitation in the noninvasive estimation of pulmonary wedge pressure by Doppler echocardiography.

Pulmonary wedge pressure (PWP) can be estimated from the ratio of transmitral early peak flow velocity to flow propagation velocity measured by Doppler. Discrepancies observed in the application of the method prompted us to design this prospective study, aimed at detecting potential limitations of the method. We studied a total of 32 patients admitted to a cardiac intensive care unit, using a Swan-Ganz catheter. Correlation between invasive- and Doppler-estimated PWP was fairly good (r = 0.58). Analysis of discrepant cases led to the identification of a subgroup of 6 patients in whom PWP was largely underestimated because of unexpectedly high values of flow propagation velocity (71 +/- 15 cm/s vs 37 +/- 10 cm/s in the rest of the group; P =.0001). All of them had in common a restrictive Doppler filling pattern and preserved left ventricular systolic function. Exclusion of this group showed an improvement in the correlation coefficient to r = 0.72. In conclusion, PWP can be estimated by the Doppler early peak flow velocity to flow propagation velocity ratio, although a significant underestimation of PWP may be observed in patients with a restrictive filling pattern and preserved ventricular function.

Blood Flow Velocity↗
PubMed1996

[Pulmonary venous flow in patients with chronic heart failure: feasibility and additional value compared to transmitral flow for non-invasive estimation of pulmonary wedge pressure].

BACKGROUND: In many cardiac conditions, Doppler of transmitral flow has been showed to be related to left ventricular filling pressure, but several factors may limit its practical value in estimating pulmonary wedge pressure in patients with chronic heart failure. Pulmonary venous velocities directly depend on the oscillations of left atrial pressure. Recent studies suggest that transthoracic Doppler of pulmonary venous flow provides a more accurate estimation of pulmonary wedge pressure. However the relative values of transmitral and pulmonary venous flow for assessing pulmonary wedge pressure in patients with chronic heart failure have not been fully classified until now. Accordingly, we performed this study to assess the feasibility of transthoracic Doppler of pulmonary venous flow in patients with chronic heart failure and to evaluate whether it provides additional information regarding pulmonary wedge pressure when compared with Doppler indices of transmitral flow. METHODS: Simultaneous Doppler echocardiographic examinations and right heart catheterizations were performed prospectively in 300 consecutive patients with chronic heart failure due to dilated cardiomyopathy. The correlations of mitral and pulmonary venous flow velocity variables, left atrial volumes, mitral regurgitation jet area and left ventricular ejection fraction with pulmonary artery wedge pressure were evaluated. RESULTS: A complete recording of transthoracic pulmonary venous flow including all components was obtained in 66% of patients, while only systolic and diastolic forward flow were recorded in 88% of patients. Several indices, derived from pulmonary venous flow, were correlated with pulmonary wedge pressure; the strongest correlation was between systolic fraction of peak velocities and pulmonary wedge pressure (r = -0.76). This value was similar to that obtained between deceleration rate (r = 0.78) and deceleration time (r = -0.67) of transmitral flow and pulmonary wedge pressure. A systolic fraction > 40% showed a greater positive predictive value than restrictive pattern of transmitral flow for identifying patients with pulmonary wedge pressure > 18 mmHg (95% vs 86% p < 0.05). This accuracy is confirmed also in patients who had a single peak of transmitral flow. CONCLUSIONS: Doppler of pulmonary venous flow can be performed in a high percentage of patients with chronic heart failure due to dilated cardiomyopathy. The indices derived from transthoracic pulmonary venous flow are strongly correlated with pulmonary wedge pressure and improve the noninvasive identification of patients with high pulmonary wedge pressure, even when transmitral flow pattern is difficult to be interpreted.

Aged↗
PubMed1978

The validity of determinations of pulmonary wedge pressure during mechanical ventilation.

Changes in the mean pulmonary wedge pressure were measured during temporary disconnection from a ventilator in 29 patients to assess the effects of therapy with controlled-volume ventilation on determinations of pulmonary wedge pressure. In 16 observations performed during therapy with intermittent positive-pressure ventilation, the mean value for the pulmonary wedge pressure was the same (10.3 mm Hg) with the patients connected to or disconnected from the ventilator. Thirteen of the patients were also maintained on therapy with positive end-expiratory pressure (PEEP); the mean (+/- SD) of 17 measurements of pulmonary wedge pressure did not show a significant variation on cessation of mechanical ventilation (12.5 +/- 6.7 mm Hg vs 11.7 +/- 6.9 mm Hg; P greater than 0.05). We conclude that pulmonary wedge pressure can be measured accurately at the end of exhalation during the administration of positive-pressure ventilation with 10 cm H2O of PEEP. The suggested practice of discontinuing mechanical ventilation in order to obtain a more exact measurement is not warranted.

Blood Pressure↗
PubMed1978

Colloid osmotic and pulmonary wedge pressures in acute respiratory failure following hemorrhage.

Acute respiratory failure evolved in five patients following hypovolemic shock related to trauma or surgical operation, or both. A reduction in colloid osmotic pressure, increases in pulmonary artery wedge pressure and reductions in colloid osmotic pressure-pulmonary artery wedge pressure gradient to levels which are likely to account for pulmonary edema were observed. Accordingly, reduction in the colloid hydrostatic pressure gradient may, in part, explain the development of acute respiratory failure after acute blood loss. In one instance, however, the absence of such reduction in the colloid osmotic pressure-pulmonary artery wedge pressure gradient together with increases in pulmonary vascular resistance showed that colloid osmotic pressure and pulmonary artery wedge pressure are not exclusively operative in the pathogenesis of the clinical syndrome of acute respiratory failure.

Acute Disease↗
PubMed1987

Alveolar hypoxia increases small pulmonary wedge pressure in awake young lambs.

Alveolar hypoxia increases pulmonary artery pressure in lambs and sheep but increases lung lymph flow only in lambs; the reasons for this are unknown. To test the hypothesis that hypoxia-induced pulmonary venous constriction could in part explain the fluid filtration response in young lambs, eight young lambs (13 +/- 3 days old) and four older lambs (60 +/- 4 days old) were prepared for chronic studies of pulmonary hemodynamics, gas exchange, and fluid filtration. In all animals, a 5 Fr catheter was intermittently wedged into a distal pulmonary artery to indirectly estimate pulmonary venous pressure. The pressure measured in this manner was termed the "small wedge pressure." Animals were awake, spontaneously breathing, and unsedated, and were exposed to both acute and chronic isocarbic hypoxia (FIO20.12). We found that hypoxia significantly increased both small pulmonary wedge pressure and lung lymph flow in young lambs but that neither of these effects occurred in the older lambs. In young lambs, the hypoxia-induced increase in small wedge pressure could be lowered by sodium nitroprusside administration, and small wedge pressure could be increased by angiotensin II infusion. We conclude that alveolar hypoxia increases pulmonary venous tone and the critical pressure of pulmonary veins in young lambs, and that these effects disappear with maturation. These data suggest that alterations in pulmonary venous tone can have important effects on lung fluid balance in the newborn.

Angiotensin II↗
PubMed1994

Estimation of pulmonary artery pressure from pulmonary vein wedge pressure.

Correlations between pulmonary artery and pulmonary vein wedge pressures were investigated in 13 patients with atrial septal defect and 1 patient with Tetralogy of Fallot. Pulmonary vein wedge pressure wave form resembled that of pulmonary artery pressure, and the former lagged behind the latter by 70 to 110 msec (mean 88 +/- 14) as observed by the fluid-filled catheter system. Diastolic pulmonary artery and diastolic pulmonary vein wedge pressures were nearly identical. Although systolic and mean pulmonary artery pressures correlated well with respective pulmonary vein wedge pressures, there were discrepancies when systolic and mean pulmonary artery pressure exceeded 35 and 20 mm Hg, respectively. However, systolic and mean pulmonary artery pressures could be estimated by adding the difference between the diastolic pulmonary vein wedge pressure and the mean left atrial pressure to corresponding systolic or mean pulmonary artery pressure. In conclusion, pulmonary artery pressures can be estimated by measuring pulmonary vein wedge pressures and the mean left atrial pressure.

Adult↗