Morris A H, Chapman R H
Crit Care Med. 1985 Sep;13(9):756-9. doi: 10.1097/00003246-198509000-00014.
In order to define the contribution of wedge blood composition to pulmonary artery wedge pressure (WP) measurement, we made 28 comparisons of WP and left atrial pressure (LAP) in 16 stable patients with pulmonary or cardiac failure after cardiac surgery. All technical problems associated with initial WP measurements were eliminated before simultaneously recording WP and LAP. Wedge blood samples (w), withdrawn from the distal pulmonary artery catheter port in the balloon occlusion position, were compared with paired arterial (a) blood samples. Wedge blood was defined as pulmonary capillary blood when the following three wedge-arterial gradient criteria were satisfied: (PwO2 - PaO2) greater than or equal to 19 torr; (PaCO2 - PwCO2) greater than or equal to 11 torr; and (pHw-pHa) greater than or equal to 0.08. When capillary blood was withdrawn from the wedge position, there was no difference between WP and LAP measurements. When wedge blood failed to satisfy capillary criteria, WP was significantly (p less than .05) different from LAP. Aspiration of capillary blood from the wedge position in ICU patients confirms that WP faithfully reflects LAP. It identifies those differences between WP and LAP which remain after technical problems are eliminated.
为了确定楔压血液成分对肺动脉楔压（WP）测量的影响，我们对16例心脏手术后患有肺或心力衰竭的稳定患者进行了28次WP与左心房压力（LAP）的比较。在同时记录WP和LAP之前，消除了所有与初始WP测量相关的技术问题。从处于球囊闭塞位置的远端肺动脉导管端口抽取的楔压血液样本（w）与配对的动脉（a）血液样本进行比较。当满足以下三个楔压-动脉梯度标准时，楔压血液被定义为肺毛细血管血：（PwO2 - PaO2）大于或等于19托；（PaCO2 - PwCO2）大于或等于11托；以及（pHw - pHa）大于或等于0.08。当从楔压位置抽取毛细血管血时，WP和LAP测量值之间没有差异。当楔压血液不满足毛细血管标准时，WP与LAP有显著差异（p小于0.05）。在重症监护病房（ICU）患者中从楔压位置抽取毛细血管血证实，WP忠实地反映了LAP。它识别出在消除技术问题后WP和LAP之间仍然存在的差异。
