Cengiz M, Crapo R O, Gardner R M
Crit Care Med. 1983 Jul;11(7):502-7. doi: 10.1097/00003246-198307000-00004.
A comparison was made of automated versus manual measurement of pulmonary artery (PA) and wedge (WP) pressures. The manual pressure measurements were taken at end-expiration whereas the automated measurements were taken using existing monitor and computer algorithms. A total of 40 critical care patients were divided into groups according to the ventilatory mode used (spontaneous, intermittent mandatory ventilation [IMV], or assist/control). In patients who were breathing spontaneously, the automated method underestimated mean PA pressure (MPAP) (p less than 0.01), WP (p less than 0.001), and PA diastolic (p less than 0.001) pressure but not PA systolic pressure. In patients on IMV, the automated method underestimated MPAP (p less than 0.05), WP (p less than 0.001), and PA diastolic (p less than 0.001) pressure and overestimated PA systolic pressure (p less than 0.05). In patients on assist/control, the automated method overestimated WP (p less than 0.001) and PA systolic (p less than 0.005) pressure pressure, underestimated PA diastolic (p less than 0.001) pressure and did not affect MPAP. The error was not affected by respiratory rate, thoracic compliance, or level of PEEP. The errors in automated pressure measurements believed to be clinically important varied with the ventilatory mode used. Patients breathing spontaneously had the largest measurement error, with 42% of these patients having a clinically important error in WP and 99% having a clinically important error in PA diastolic pressure. Patients on assist/control had the fewest errors in automated pressure measurements. In all ventilatory modes used, automated measurement of PA diastolic pressure had the largest amount of error.
对肺动脉（PA）压和楔压（WP）的自动测量与手动测量进行了比较。手动压力测量在呼气末进行，而自动测量则使用现有的监测器和计算机算法。根据所使用的通气模式（自主呼吸、间歇指令通气[IMV]或辅助/控制通气）将40例重症监护患者分为几组。在自主呼吸的患者中，自动测量方法低估了平均肺动脉压（MPAP）（p<0.01）、楔压（p<0.001）和肺动脉舒张压（p<0.001），但未低估肺动脉收缩压。在接受IMV的患者中，自动测量方法低估了MPAP（p<0.05）、楔压（p<0.001）和肺动脉舒张压（p<0.001），并高估了肺动脉收缩压（p<0.05）。在接受辅助/控制通气的患者中，自动测量方法高估了楔压（p<0.001）和肺动脉收缩压（p<0.005），低估了肺动脉舒张压（p<0.001），且对MPAP无影响。误差不受呼吸频率、胸廓顺应性或呼气末正压水平的影响。自动压力测量中被认为具有临床重要性的误差因所使用的通气模式而异。自主呼吸的患者测量误差最大，其中42%的患者楔压存在具有临床重要性的误差，99%的患者肺动脉舒张压存在具有临床重要性的误差。接受辅助/控制通气的患者自动压力测量的误差最少。在所有使用的通气模式中，肺动脉舒张压的自动测量误差最大。
