Comparison of Central Venous Pressure, Diastolic Pulmonary Artery Pressure and Pulmonary Capillary Wedge Pressure and Pulmonary Capillary Wedge Pressure as Estimates of Left Atrial Pressure.

Jo,  Dae Hyun; Kim,  Yong Joo; Kim,  Yong Lak

doi:1996.30.2.172

Clinical Research Article

Korean Journal of Anesthesiology 1996;30(2):172-177.
DOI: https://doi.org/10.4097/kjae.1996.30.2.172

Comparison of Central Venous Pressure, Diastolic Pulmonary Artery Pressure and Pulmonary Capillary Wedge Pressure and Pulmonary Capillary Wedge Pressure as Estimates of Left Atrial Pressure.

Dae Hyun Jo, Yong Joo Kim, Yong Lak Kim

Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.

Abstract

BACKGROUND
To evaluate the left heart function, left atrial pressure(LAP) has been monitored directly via LA catheter and indirectly via Swan-Ganz catheter. But indirect pressure monitor cannot often reflect the LAP precisely. We compared the LAP via LA catheter with central venous pressure(CVP), diastolic pulmonary artery pressure(DPAP) and pulmonary capillary wedge pressure(PCWP) by Swan-Ganz catheter.
METHODS
Eleven cardiac-surgical patients whose LAP measurements were needed for clinical management were the subjects of this study. The CVP, DPAP and PCWP by Swan-Ganz catheter, and LAP were measured just after cardiopulmonary bypass, just after sternal closure, after 6 hours and 18 hours from the end of operation. And we divided them into two groups which consisted below 35 mmHg(group I) and over 35 mmHg(group II) of systolic pulmonary artery pressure(SPAP), and compared two groups.
RESULTS
In group I, the LAP, CVP, DPAP and PCWP was 11.7+/-3.9 mmHg, 10.5+/-3.9 mmHg, 12.5+/-5.1 mmHg and 12.5+/-4.4 mmHg respectively, and correlation coefficiency of LAP with CVP, DPAP and PCWP was 0.7478, 0.7128 and 0.9002 respectively(p<0.05). In the group II, the LAP, CVP, DPAP and PCWP was 16.5+/-3.2 mmHg, 12.8+/-2.9 mmHg, 23.4+/-3.8 mmHg and 20.8+/-4.7 mmHg respectively and there was no correlation between LAP, CVP, DPAP and PCWP.
CONCLUSIONS
The Swan-Ganz catheterization for the estimation of LAP is useful in the patients without pulmonary hypertension, but in the patient with pulmonary hypertension, CVP, DPAP and PCWP do not reflect the LAP.

Key Words: Monitoring; central venous pressure; diastolic pulmonary artery pressure; left atrial pressure; pulmonary capillary wedge pressure