Wedge print

The (pulmonary capillary ) wedge pressure or pulmonary capillary occlusion pressure , abbreviated PWP , PCWP or PAWP according to the English Pulmonary (Capillary / Arterial) Wedge Pressure , is an expression for a measured value that can be recorded in the pulmonary circulation using a catheter. It is important in special cardiopulmonary diagnostics, especially in emergency and intensive care medicine . It describes the pressure that occurs when a small branch of the pulmonary artery (arteria pulmonalis) is temporarily closed (blocked with a balloon) using a balloon catheter ( pulmonary artery catheter developed by Jeremy Swan and William Ganz - hence also called Swan-Ganz catheter ) in Wedge position (English wedge = wedge; to wedge = to wedge oneself, to clamp oneself) is measured distal to the blocked balloon.

Under physiological conditions, the wedge pressure corresponds to the pressure conditions in the small circulation and in the left atrium and thus to the preload of the left ventricle (the pressure conditions in the left ventricle can - apart from patients with absolute arrhythmia and atrial fibrillation or an AV node rhythm - by a Right heart catheter cannot be assessed).

The normal range for the wedge pressure is between 5 and 16 mmHg with an exact calibration of the zero point.

An increase in PCWP occurs in the initial phase of cardiogenic shock due to acute left heart failure, followed by a decrease in stroke volume , and can also indicate a left ventricular myocardial infarction , acute ventricular septal rupture, or pericardial tamponade .

The PCWP can be used to assess the patient's hydration status. The wedge pressure is reduced in hypovolemia , but also in right ventricular myocardial infarction and early sepsis.

swell

Jochen Schulte am Esch, Eberhard Kochs, Hanswerner Bause: Anesthesia and intensive medicine , 2nd edition, November 2006, Thieme-Verlag
T. Hamp, D. Weidenauer: Textbook Tertial Emergency and Intensive Care Medicine , 2012 Springer Verlag 2nd edition; ISBN 978-3-7091-1012-6

Individual evidence

↑ D. Scheidegger: Definition and parameters of acute respiratory insufficiency: pulmonary circulation, cardiac function. In: J. Kilian, H. Benzer, FW Ahnefeld (ed.): Basic principles of ventilation. Springer, Berlin a. a. 1991, ISBN 3-540-53078-9 , 2nd, unchanged edition, ibid 1994, ISBN 3-540-57904-4 , pp. 109-120; here: pp. 114–116.
↑ Amitava Majumder, Anne Paschen: Medical working techniques. In: Jörg Braun, Roland Preuss (Ed.): Clinic Guide Intensive Care Medicine. 9th edition. Elsevier, Munich 2016, ISBN 978-3-437-23763-8 , pp. 29-93, here: p. 39 f .: Pulmonary catheter (Swan-Ganz catheter).
↑ Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 133 f.
↑ http://www.healthsystem.virginia.edu/internet/anesthesiology-elective/cardiac/pacphys.cfm
↑ Amitava Majumder, Anne Paschen: Medical working techniques. In: Jörg Braun, Roland Preuss (Ed.): Clinic Guide Intensive Care Medicine. 9th edition. Elsevier, Munich 2016, ISBN 978-3-437-23763-8 , pp. 29–93, here: pp. 39–41: Pulmonary catheter (Swan-Ganz catheter) .
↑ Amitava Majumder, Anne Paschen (2016), p. 40.

[1] D. Scheidegger: Definition and parameters of acute respiratory insufficiency: pulmonary circulation, cardiac function. In: J. Kilian, H. Benzer, FW Ahnefeld (ed.): Basic principles of ventilation. Springer, Berlin a. a. 1991, ISBN 3-540-53078-9 , 2nd, unchanged edition, ibid 1994, ISBN 3-540-57904-4 , pp. 109-120; here: pp. 114–116.

[2] Amitava Majumder, Anne Paschen: Medical working techniques. In: Jörg Braun, Roland Preuss (Ed.): Clinic Guide Intensive Care Medicine. 9th edition. Elsevier, Munich 2016, ISBN 978-3-437-23763-8 , pp. 29-93, here: p. 39 f .: Pulmonary catheter (Swan-Ganz catheter).

[3] Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 133 f.

[4] ttp://www.healthsystem.virginia.edu/internet/anesthesiology-elective/cardiac/pacphys.cfm

[5] Amitava Majumder, Anne Paschen: Medical working techniques. In: Jörg Braun, Roland Preuss (Ed.): Clinic Guide Intensive Care Medicine. 9th edition. Elsevier, Munich 2016, ISBN 978-3-437-23763-8 , pp. 29–93, here: pp. 39–41: Pulmonary catheter (Swan-Ganz catheter) .

[6] Amitava Majumder, Anne Paschen (2016), p. 40.