Effect of airway pressure display on interobserver agreement in the assessment of vascular pressures in patients with acute lung injury and acute respiratory distress syndrome*

Abstract

Paw display is a simple, inexpensive method to facilitate the identification of end-expiration that can significantly improve interobserver agreement.

“Expiratory holding” approach in measuring end-expiratory pulmonary artery wedge pressure for mechanically ventilated patients

“…In the FACTT trial4 in 2005, the two approaches were combined, demonstrating promising results. However, we found that there are some disadvantages in this approach.…”

“…The experimental group was established as described in the FACTT trial 4. The detailed PAWP measurement procedure was established, and systemic training of all of the staff members was performed.…”

“…Before each measurement, the mechanical zero and electric zero positions were adjusted. The airway pressure display approach was conducted as described previously,4 with sample results shown in Figure 1. The end of expiration was identified by drawing a vertical line 200 ms before the initial positive or negative pulmonary artery wedge deflection of each breath.…”

“…The measurement of end-expiratory PAWP (eePAWP) has, therefore, attracted much attention, and various approaches have been developed 2,3. The Fluids and Catheters Treatment Trial4 (FACTT) in 2005 showed that the airway pressure display approach led to good results for eePAWP measurement; however, the procedure was complicated, leading to low compliance for the user.…”

Severe Malaria: Metabolic Complications

“…In the presence of microvascular obstruction there may be localised shunting of blood around areas of Central venous pressure (CVP) measurements do not directly measure circulating volume [94] and have variable reliability [95]. CVP measurements have been reported as being low in some studies [80] and not in others [93].…”