Morris A H, Chapman R H, Gardner R M
Crit Care Med. 1984 Mar;12(3):164-70. doi: 10.1097/00003246-198403000-00003.
A total of 2711 pulmonary artery wedge pressure (WP) measurement attempts were made prospectively from WP recordings in 44 (30 men) critically ill patients, using 77 flow-directed catheters. Of these, 322 (12%) failed to yield a WP measurement, and 521 (18%) were associated with technical problems. One half of these technical problems were due to poor dynamic response or damped pressure tracings; other problems included balloon overinflation, partial WP, and inability to aspirate blood from the pulmonary artery (PA) port. Only 50% of wedge blood sampled at the time of initial PA catheterization yielded capillary blood (PO2 greater than or equal to 10 torr higher than PaO2). In 12 stable patients in whom paired measurements were available, there were clinically important differences (-13 to +22 torr) between paired WP measurements made before and after rapid correction of technical problems. Technical problems are common and may be associated with clinically important errors. Those due to poor dynamic response are easily and rapidly detected at the bedside.
前瞻性地对44例（30例男性）危重症患者使用77根血流导向导管的肺动脉楔压（WP）记录进行了总共2711次WP测量尝试。其中，322次（12%）未能获得WP测量值，521次（18%）存在技术问题。这些技术问题中有一半是由于动态反应不佳或压力波形衰减；其他问题包括球囊过度充气、部分WP以及无法从肺动脉（PA）端口抽吸血液。在初始PA导管插入时采集的楔压血样中，只有50%产生了毛细血管血（PO2比PaO2高10 torr或更高）。在12例可进行配对测量的稳定患者中，技术问题快速纠正前后的配对WP测量值之间存在临床上重要的差异（-13至+22 torr）。技术问题很常见，可能与临床上重要的误差相关。那些由于动态反应不佳导致的问题在床边很容易快速检测到。
