Pulmonary wedge pressure
The pulmonary wedge pressure (PWP) (also called pulmonary arterial wedge pressure (PAWP), pulmonary capillary wedge pressure (PCWP), pulmonary artery occlusion pressure (PAOP), or cross-sectional pressure) is the pressure measured by wedging a pulmonary artery catheter with an inflated balloon into a small pulmonary arterial branch.[1] It estimates the left atrial pressure.
Pulmonary venous wedge pressure (PVWP) is not synonymous with the above; PVWP has been shown to correlate with pulmonary artery pressures in studies, albeit unreliably.[citation needed]
Physiologically, distinctions can be drawn among pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary venous pressure and left atrial pressure, but not all of these can be measured in a clinical context.[2]
Noninvasive estimation techniques have been proposed.[3]
Clinical significance
Site | Normal pressure range (in mmHg)[4]
| |
---|---|---|
Central venous pressure | 3–8 | |
Right ventricular pressure |
systolic | 15–30 |
diastolic | 3–8 | |
Pulmonary artery pressure | systolic | 15–30 |
diastolic | 4–12 | |
Pulmonary vein/ |
2–15 | |
Left ventricular pressure |
systolic | 100–140 |
diastolic | 3–12 |
Because of the large compliance of
For example, it is considered the gold standard for determining the cause of
Traditionally, it was believed that pulmonary edema with normal PWP suggested a diagnosis of acute respiratory distress syndrome (ARDS) or non cardiogenic pulmonary edema (as in opiate poisoning). However, since capillary hydrostatic pressure exceeds wedge pressure once the balloon is deflated (to promote a gradient for forward flow), a normal wedge pressure cannot conclusively differentiate between hydrostatic pulmonary edema and ARDS.[citation needed]
Physiological pressure: 6–12 mm Hg.[8]
References
- ISBN 978-0-340-80782-8.
- S2CID 25152352.
- S2CID 25261136.
- ISBN 978-0-7817-7447-5.
- ^ "Gun Shot Wound Case Study Discussion". Archived from the original on 2009-01-08. Retrieved 2009-03-02.
- ^ "CV Physiology".
- ^ Harrison's Principles of Internal Medicine. 14th edition. Chapter 38, page 243.
- ^ "Pulmonary Capillary Wedge Pressure". 22 July 2020.
External links
- Overview at cvphysiology.com
- Pulmonary+wedge+pressure at the U.S. National Library of Medicine Medical Subject Headings (MeSH)