PEEP-Induced Changes of Pulmonary Capillary Wedge Pressure, Prepulmonary and Total Intrathoracic Blood Volume in Anesthetized Dogs

  • H. Wellhöfer
  • J. Zeravik
  • M. Perker
  • G. Blümel
  • G. Zimmermann
  • U. J. Pfeiffer
Conference paper


Since the introduction of the flow-directed pulmonary artery catheter by Swan et al [30] the pulmonary capillary wedge pressure (PCWP) has been applied more and more as an indicator of circulating volume status. It has been thought that left atrial pressure (LAP) reflects LV preload. Therefore experimental and clinical evaluations of the pulmonary artery catheter were focussed on comparisons between PCWP and LAP, and it was found that there is an acute correlation between LAP and PCWP during spontaneous breathing (SB) and intermittent positive pressure ventilation (IPPV) [1, 5, 9, 12, 15, 17, 34].


Mean Arterial Pressure Right Ventricle Pulmonary Capillary Wedge Pressure Pulmonary Artery Catheter Right Atrium 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Batson GA, Chandrasekhar KP, Payas Y, Rickards DF (1972) Measurement of pulmonary wedge pressure by flow directed Swan-Ganz catheter. Cardiovasc Res 6: 748–752PubMedCrossRefGoogle Scholar
  2. 2.
    Bellamy PE, Mercurio P (1986) An alternative method for coordinating pulmonary capillary wedge pressure measurements with the respiratory cycle. Crit Care Med: 14: 733–734PubMedCrossRefGoogle Scholar
  3. 3.
    Berne RM, Levy MN (1983) The cardiovascular system. In: Berne RM, Levy MN (eds) Physiology. Mosby, St. Louis, pp 439–623Google Scholar
  4. 4.
    Berryhill RE, Benumo JL, Raucher LA (1978) Pulmonary vascular pressure reading at the end of exhalation. Anesthesiology 49: 365–369PubMedCrossRefGoogle Scholar
  5. 5.
    Buchbinder N, Ganz W (1976) Hemodynamic monitoring: invasive techniques. Anesthesiology 45: 146–155PubMedCrossRefGoogle Scholar
  6. 6.
    Calvin JE, Driedger AA, Sibbald WJ (1981) Positive end-expiratory pressure (PEEP) does not depress left ventricular function in patients with pulmonary edema. Am Rev Resp Dis 124: 121–128PubMedGoogle Scholar
  7. 7.
    Cassidy SS, Ramanathan M (1984) Dimensional analysis of the left ventricle during PEEP: relative septal and lateral wall displacements. Am J Physiol 15: H792–H805Google Scholar
  8. 8.
    Davison R, Parker M, Harrison RA (1978) The validity of determinations of pulmonary wedge pressure during mechanical ventilation. Chest 73: 352–358PubMedCrossRefGoogle Scholar
  9. 9.
    De Laurentis DA, Hayes M, Matsumoto T, Wolferth CC (1972) Does central venous pressure accurately reflect hemodynamic and fluid volume patterns in the critical surgical patient? Am J Surg 126: 415–418CrossRefGoogle Scholar
  10. 10.
    Divertie MB, McMichan JC, Michel L, Offord KP, Ness AB (1983) Avoidance of aggravated hypoxemia during measurement of mean pulmonary artery wedge pressure in ARDS. Chest 83: 70–74PubMedCrossRefGoogle Scholar
  11. 11.
    Fewell, JE, Abendschein DR, Carlson CJ, Rapaport E, Murray JF (1981) Continuous positive pressure ventilation does not alter ventricular pressure volume relationships. Am J Physiol 240: H821–H826PubMedGoogle Scholar
  12. 12.
    Fitzpatrick DF, Hampson LG, Burgess JH (1972) Bedside determination of left atrial pressure. Can Med Assoc J 106: 1293–1298PubMedGoogle Scholar
  13. 13.
    Gershan JA (1983) Effect of positive end-expiratory pressure on pulmonary capillary wedge pressure. Heart Lung 12: 143–148PubMedGoogle Scholar
  14. 14.
    Haynes JB, Carson SD, Whitney WP, Zerbe GO, Hyers TM, Steele P (1980) Positive end-expiratory pressure shifts left ventricular diastolic pressure-area curves. J Appl Physiol 48: 670–676PubMedGoogle Scholar
  15. 15.
    Humphrey CB, Oury JH, Virgilio RW, Gibbons JA, Folkerth TL, Shapiro AR, Fosburg RG (1976) An analysis of direct and indirect measurements of left atrial filling pressure. J Thorac Cardiovasc Surg 71: 643–647PubMedGoogle Scholar
  16. 16.
    Jardin F, Farcot JC, Guret P, Prost JF, Ozier Y, Bourdarias JP (1984) Echocardiographic evaluation of ventricles during continuous positive airway pressure breathing. J Appl Physiol 56: 619–627PubMedGoogle Scholar
  17. 17.
    Lappas D, Lell WA, Gabel JC, Civetta JM, Lowenstein E (1973) Indirect measurement of left-atrial pressure in surgical patients. Pulmonary-capillary wedge and pulmonary artery diastolic pressures compared with left-atrial pressure. Anesthesiology 38: 394–397PubMedCrossRefGoogle Scholar
  18. 18.
    Laver MB, Strauss WH, Pohost GM(1979) Right and left ventricular geometry adjustments during acute respiratory failure. Crit Care Med 7: 507– 519CrossRefGoogle Scholar
  19. 19.
    Marini JJ, Culver BH, Butler J (1981) Effect of positive end-expiratory pressure on canine ventricular function curves. J Appl Physiol 51: 1367– 1374PubMedGoogle Scholar
  20. 20.
    Marini JJ, Culver BH, Butler J (1981) Mechanical effect of lung distension with positive pressure on cardiac function. Am Rev Resp Dis 124: 282–286Google Scholar
  21. 21.
    O’Quin R, Marini JJ (1983) Pulmonary artery occlusion pressure: clinical physiology, measurement and interpretation. Am Rev Respir Dis 128: 319–326PubMedGoogle Scholar
  22. 22.
    Pace NL (1977) A critique of flow-directed pulmonary arterial catheterization. Anesthesiology 47: 455–465PubMedCrossRefGoogle Scholar
  23. 23.
    Pfeiffer U, Birk M, Kohler W, Sagerer M, Blümel G (1981) Extravasales Lungenwasser und plasmakolloidosmotischer Druck bei der pulmonalen Mikroembolie. Chir Forum 81: 28–32Google Scholar
  24. 24.
    Rankin JS, Olsen CO, Arentzen CE, Tyson GS, Maier G, Smith PK, Hammon JW, Davis JW, McHale PA, Anderson RW, Sabiston DC (1982) The effects of airway pressure on cardiac function in intact dogs and man. Circulation 66: 108–120PubMedCrossRefGoogle Scholar
  25. 25.
    Rice RL, Awe RJ, Gaasch WH (1974) Wedge pressure measurements in obstructive pulmonary disease. Chest 66: 628–632PubMedCrossRefGoogle Scholar
  26. 26.
    Robertson CH, Cassidy SS (1976) Distribution of the reduced cardiac output induced by continuous positive-pressure breathing. Physiologist 19: 341–344Google Scholar
  27. 27.
    Schreuder JJ, Jansen JRC, Versprille A (1985) Hemodynamic effects of PEEP applied as a ramp in normo-, hyper-, and hypovolemia. J Appl Physiol 59: 1178–1184PubMedGoogle Scholar
  28. 28.
    Shasby DA, Dauber IA, Pfister S, Anderson JT, Carson SB, Manart F, Myers TM (1981) Swan-Ganz catheter location and left atrial pressure determine the accuracy of the wedge pressure when positive end-expiratory pressure is used. Chest 80: 666–670PubMedCrossRefGoogle Scholar
  29. 29.
    Sibbald WJ, Driedger AA, Meyers ML, Short AJ, Wells GA (1983) Biventricular function in the adult respiratory distress syndrome. Chest 84: 126–134PubMedCrossRefGoogle Scholar
  30. 30.
    Swan HJC, Ganz W, Forrester J, Marcus H, Diamond G, Chonette D (1970) Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med 283: 447– 451PubMedCrossRefGoogle Scholar
  31. 31.
    Tooker J, Huseby J, Butler J (1978) The effect of Swan-Ganz catheter height on the wedge pressure-left atrial pressure relationship in edema during positive pressure ventilation. Am Rev Resp Dis 117: 721–725PubMedGoogle Scholar
  32. 32.
    Vatner SF, Boettcher DH (1978) Regulation of cardiac output by stroke volume and heart rate in conscious dogs. Circ Res 42: 557PubMedGoogle Scholar
  33. 33.
    Vlahakes GJ, Turley K, Hoffman JIE (1981) The pathophysiology of failure in acute right ventricular hypertension: hemodynamic and biochemical correlations. Circulation 63: 87–95PubMedCrossRefGoogle Scholar
  34. 34.
    Walston A, Kendall ME (1973) Comparison of pulmonary wedge and left atrial pressure in man. Am Heart J 86: 159–164PubMedCrossRefGoogle Scholar
  35. 35.
    Wise RA, Robotham JL, Bromberger-Barnea B, Permutt S (1981) Effect of PEEP on left ventricular function in right-heart-bypassed dogs. J Appl Physiol 51: 541–546PubMedGoogle Scholar
  36. 36.
    Zarins CK, Virgilio RW, Smith DE, Peters RM (1977) The effect of vascular volume on positive end-expiratory pressure induced cardiac output depression and wedge-left atrial pressure discrepancy. J Surg Res 23: 348–360PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • H. Wellhöfer
  • J. Zeravik
  • M. Perker
  • G. Blümel
  • G. Zimmermann
  • U. J. Pfeiffer

There are no affiliations available

Personalised recommendations