“Expiratory holding” approach in measuring end-expiratory pulmonary artery wedge pressure for mechanically ventilated patients

Abstract

Wanjie Yang,1 Xuefeng Zhao,1 Qingguo Feng,1 Youzhong An,2 Kai Wei,1 Wei Wang,1 Chang Li,1 Xiuling Cheng1 1Intensive Care Unit, the Fifth Central Hospital of Tianjin, Tianjin, People’s Republic of China; 2Intensive Care Unit, Peking University People’s Hospital, Beijing, People’s Republic of China Objective: To accurately measure the end-expiratory pulmonary artery wedge pressure (PAWP) with the “expiration holding” function on the ventilator and the “pulmonary artery wedge pressure review” software on the monitor. Materials and methods: Fifty prospective measurements were made on 12 patients undergoing pulmonary artery catheter and mechanical ventilation. All measurements were divided into <8 mmHg or ≥8 mmHg subgroups according to respiratory variability, and they were then subdivided into either an airway pressure display measurement group (AM group) or an expiration holding (EH) group for comparison. Results: In all measurements, the two groups showed similar levels of accuracy; however, for the time spent for measurement, the EH group was much faster than the airway pressure display measurement group (P<0.001). Additionally, the EH group was associated with lower medical costs. Conclusion: The expiration holding approach measured the PAWP more accurately, more quickly, and with reduced costs in comparison to the airway pressure display approach. Keywords: expiration holding, pulmonary artery wedge pressure, eePAWP, mechanical ventilation, pulmonary artery catheter