Benumof J L, Saidman L J, Arkin D B, Diamant M
Anesthesiology. 1977 May;46(5):336-8. doi: 10.1097/00000542-197705000-00007.
Recent experimental evidence indicates that the position of a pulmonary arterial catheter within the thorax is important because vertical height gradients from catheter tip to main pulmonary artery and left atrium may alter the validity of the pressure measured. The authors therefore examined the intrathoracic distribution of 314 pulmonary arterial catheters which at insertion were advanced to the most proximal position from which pulmonary wedge pressure could be obtained. Five catheters (1.8 per cent) were 6 cm or more cephalad to the carina, and 16 (5.1 per cent) were 9 cm or more lateral to the midline. With peripheral catheters recordings of pulmonary arterial and wedge pressures may be erroneous because future patient position, initiation of positive end-expiratory pressure, and occurrence of low pulmonary arterial and left atrial pressures may convert the region of lung in which the catheter tip lies to a Zone 1 of the lung.
最近的实验证据表明，肺动脉导管在胸腔内的位置很重要，因为从导管尖端到主肺动脉和左心房的垂直高度梯度可能会改变所测压力的有效性。因此，作者检查了314根肺动脉导管在胸腔内的分布情况，这些导管在插入时被推进到能获得肺楔压的最近端位置。5根导管（1.8%）位于隆突上方6厘米或更远，16根（5.1%）位于中线外侧9厘米或更远。对于外周导管，肺动脉压和楔压的记录可能有误，因为患者未来的体位、呼气末正压的启动以及低肺动脉压和左心房压的出现，可能会使导管尖端所在的肺区域转变为肺的1区。
