14-7
14.8
Measuring PAWP
Pulmonary Artery Wedge Pressure (PAWP) values, used to assess cardiac function, are affected by fluid status, myocardial
contractility, and valve and pulmonary circulation integrity.
Obtain the measurement by introducing a balloon-tipped pulmonary artery flotation catheter into the pulmonary artery.
When the catheter is in one of the smaller pulmonary arteries, the inflated balloon occludes the artery allowing the
monitor to record changes in the intrathoracic pressures that occur throughout the respiration cycle.
The pulmonary wedge pressure is the left ventricular end diastolic pressure when the airway pressure and valve function
are normal. The most accurate PAWP values are obtained at the end of the respiration cycle when the intrathoracic
pressure is fairly constant and the artifact caused by respiration is minimal.
14.8.1
Preparing to Measure PAWP
1. Connect the parts such as catheter, syringe, etc. and use the balloon inflation port.
2. Connect the PAWP cable into the IBP connector on the monitor. Since PAWP is measured on PA, selecting [
PA
] as
the IBP label is recommended.
3. Select the PA parameter window or waveform area to enter its setup menu. Then, select [
PAWP
] to enter the PAWP
measurement window. You can also enter the PAWP measurement window from the P1-P4 parameter window.
NOTE
After entering the PAWP measurement window, the monitor will turn off the PA alarm automatically.
14.8.2
Setting Up the PAWP Measurement
1. Wedge the flotation catheter into the pulmonary artery. Then inflate the balloon and pay attention to PA waveform
changes on the screen.
2. After obtaining a stable PAWP waveform, press the [
Freeze
] key to freeze the waveform and deflate the balloon.
3. You can adjust the PAWP scale to an appropriate position by adjusting
or
beside the [
Adjust
] button.
Press the [
Confirm
] key to save one PAWP measurement.
4. If you need to start a new measurement, select [
Next Measure
].
WARNING
Prolonged inflation can cause pulmonary hemorrhage, infarction or both. Inflate the balloon for the
minimum time necessary to get an accurate measurement.
If the PAWP is greater than the PA (systolic), deflate the balloon and report the incident in accordance with
hospital policy. Because the pulmonary artery could be accidentally ruptured, and the PAWP value derived
will not reflect the patient’s hemodynamic state, but will merely reflect the pressure in the catheter or
balloon.
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