WordNet

the force applied to a unit area of surface; measured in pascals (SI unit) or in dynes (cgs unit); "the compressed gas exerts an increased pressure" (同)pressure level, force per unit area
an oppressive condition of physical or mental or social or economic distress
the somatic sensation that results from applying force to an area of skin; "the sensitivity of his skin to pressure and temperature was normal" (同)pressure_sensation
a force that compels; "the public brought pressure to bear on the government"
squeeze like a wedge into a tight space; "I squeezed myself into the corner" (同)squeeze, force
any shape that is triangular in cross section (同)wedge_shape, cuneus
(golf) an iron with considerable loft and a broad sole
something solid that is usable as an inclined plane (shaped like a V) that can be pushed between two things to separate them
having been taken in marriage (同)wedded

PrepTutorEJDIC

〈U〉『押すこと』,『押しつけること』,圧搾,圧縮;〈C〉〈U〉『圧力』,圧力の強さ / 〈U〉『圧迫』,『強制』 / 〈U〉(不快な)圧迫感 / 〈C〉〈U〉(精神的な)重荷,苦脳;(時間・金銭的)切迫 / 〈U〉多忙,あわただしさ / 《おもに米》…‘に'圧力をかける,強制する(《英》pressurise)
(特に,木製の)『くさび』 / 『くさび形の物』;くさびのような働きをするもの / (ゴルフの)ウェッジ(頭部がくさび形の短いアイアンクラブ) / …‘に'くさびを打ち込む / (…に)…‘を'無理に押し込んで動けないようにする《+名+in(into)+名》 / (…に)無理に割り込む,押し入る《+into+名》
…‘と'結婚する,‘を'妻(夫)にする / 結婚する
肺の;肺を冒す
くぎ付けになった

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/15 00:51:04」(JST)

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Diagram of Pulmonary artery catheter

The pulmonary wedge pressure or PWP, or cross-sectional pressure (also called the pulmonary arterial wedge pressure or PAWP, pulmonary capillary wedge pressure or PCWP, pulmonary venous wedge pressure or PVWP, or pulmonary artery occlusion pressure or PAOP), is the pressure measured by wedging a pulmonary catheter with an inflated balloon into a small pulmonary arterial branch.^[1]

Physiologically, distinctions can be drawn among pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary venous pressure and left atrial pressure, but not all of these can be measured in a clinical context.^[2]

Noninvasive estimation techniques have been proposed.^[3]

Clinical significance

Site		Normal pressure range (in mmHg)^[4]
Central venous pressure		3–8
Right ventricular pressure	systolic	15–30
Right ventricular pressure	diastolic	3–8
Pulmonary artery pressure	systolic	15–30
Pulmonary artery pressure	diastolic	4–12
Pulmonary vein/ Pulmonary capillary wedge pressure		2–15
Left ventricular pressure	systolic	100–140
Left ventricular pressure	diastolic	3-12

Because of the large compliance of the pulmonary circulation^{[citation needed]}, it provides an indirect measure of the left atrial pressure.^[5]

For example, it is considered the gold standard for determining the cause of acute pulmonary edema; this is likely to be present at a PWP of >20mmHg. It has also been used to diagnose severity of left ventricular failure and mitral stenosis,^[6] given that elevated pulmonary capillary wedge pressure strongly suggests failure of left ventricular output.^[7]

Traditionally, it was believed that pulmonary edema with normal PWP suggested a diagnosis of acute respiratory distress syndrome (ARDS) or non cardiogenic pulmonary edema (as in opiate poisoning). However, since capillary hydrostatic pressure exceeds wedge pressure once the balloon is deflated (to promote a gradient for forward flow), a normal wedge pressure cannot conclusively differentiate between hydrostatic pulmonary edema and ARDS.

Physiological pressure: 6–12 mm Hg.^[8]

References

^ Peacock, Andrew J.; Lewis J. Rubin (2004). Pulmonary Circulation: Diseases and their treatment. Arnold Publisher. ISBN 0-340-80782-2.
^ Chaliki HP, Hurrell DG, Nishimura RA, Reinke RA, Appleton CP (July 2002). "Pulmonary venous pressure: relationship to pulmonary artery, pulmonary wedge, and left atrial pressure in normal, lightly sedated dogs". Catheter Cardiovasc Interv 56 (3): 432–8. doi:10.1002/ccd.10203. PMID 12112902.
^ Uzun M, Erinc K, Kirilmaz A et al. (November 2004). "A novel method to estimate pulmonary artery wedge pressure using the downslope of the Doppler mitral regurgitant velocity profile". Echocardiography 21 (8): 673–9. doi:10.1111/j.0742-2822.2004.03174.x. PMID 15546367.
^ Table 30-1 in: Trudie A Goers; Washington University School of Medicine Department of Surgery; Klingensmith, Mary E; Li Ern Chen; Sean C Glasgow (2008). The Washington manual of surgery. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 0-7817-7447-0.
^ "Gun Shot Wound Case Study Discussion". Retrieved 2009-03-02.
^ "CV Physiology".
^ Harrison's Principles of Internal Medicine. 14th edition. Chapter 38, page 243.
^ "Pulmonary Capillary Wedge Pressure".

External links

-1113980888 at GPnotebook
Overview at cvphysiology.com
Description at virginia.edu
Pulmonary wedge pressure at the US National Library of Medicine Medical Subject Headings (MeSH)

UpToDate Contents

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1. 肺動脈カテーテル法：トレーシングの解釈 pulmonary artery catheterization interpretation of tracings
2. 心臓カテーテル検査法：正常な血行動態 cardiac catheterization techniques normal hemodynamics
3. 心原性肺水腫の病態生理 pathophysiology of cardiogenic pulmonary edema
4. 頸動脈内膜剥離術および頸動脈ステント留置術の麻酔 anesthesia for carotid endarterectomy and carotid stenting
5. 非心原性肺水腫 noncardiogenic pulmonary edema

English Journal

Osteopontin-mediated myocardial fibrosis in heart failure: a role for lysyl oxidase?

López B, González A, Lindner D, Westermann D, Ravassa S, Beaumont J, Gallego I, Zudaire A, Brugnolaro C, Querejeta R, Larman M, Tschöpe C, Díez J.SourceDivision of Cardiovascular Sciences, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain.
Cardiovascular research.Cardiovasc Res.2013 Jul 1;99(1):111-120. Epub 2013 Apr 25.
AIMS: We investigated whether the pro-fibrotic matricellular protein osteopontin (OPN) is associated with the enzymes involved in the extracellular synthesis of fibril-forming collagen type I (i.e. procollagen C-proteinase, PCP) and its cross-linking to form insoluble fibrils (i.e. lysyl oxidase, LO
PMID 23619422

Haemodynamic response during low-dose dobutamine infusion in patients with chronic systolic heart failure: comparison of echocardiographic and invasive measurements.

Egstrup M, Gustafsson I, Andersen MJ, Kistorp CN, Schou M, Tuxen CD, Møller JE.SourceDepartment of Cardiology and Endocrinology, Frederiksberg University Hospital, Nordre Fasanvej 59, Frederiksberg 2000, Denmark.
European heart journal cardiovascular Imaging.Eur Heart J Cardiovasc Imaging.2013 Jul;14(7):659-67. doi: 10.1093/ehjci/jes234. Epub 2012 Nov 6.
AIMS: To investigate whether left ventricular (LV) systolic shortening velocity (s'), diastolic lengthening velocity (e'), and non-invasively estimated LV filling pressure (E/e') during low-dose dobutamine echocardiography (LDDE) reflect invasive measures of cardiac output and pulmonary capillary we
PMID 23136446

Acute respiratory distress syndrome after pulmonary resection.

Kometani T, Okamoto T, Yoshida S, Yoshino I.SourceDepartment of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan, kometakukometaku@gmail.com.
General thoracic and cardiovascular surgery.Gen Thorac Cardiovasc Surg.2013 Jun 18. [Epub ahead of print]
Postoperative acute respiratory distress syndrome (ARDS) is a recognized complication of pulmonary resection. It is characterized by the acute onset of hypoxemia with radiographic infiltrates consistent with pulmonary edema, without elevations in the pulmonary capillary wedge pressure. Many studies
PMID 23775234

Japanese Journal

Hyponatremia as a Predictor for Worsening Heart Failure in Patients Receiving Cardiac Resynchronization Therapy

Arao Kenshiro,Fujiwara Takayuki,Sakakura Kenichi,Wada Hiroshi,Sugawara Yoshitaka,Suga Chikashi,Ako Junya,Ishikawa San-e,Momomura Shin-ichi
Circulation Journal 77(1), 116-122, 2013
… At baseline, serum sodium concentration negatively correlated with pulmonary capillary wedge pressure (r=－0.71, P<0.001) and with plasma arginine vasopressin level (r=－0.68, P=0.008). …
NAID 130001870122

Low-Dose β-Blocker in Combination With Milrinone Safely Improves Cardiac Function and Eliminates Pulsus Alternans in Patients With Acute Decompensated Heart Failure

KOBAYASHI Shigeki,SUSA Takehisa,TANAKA Takeo,MURAKAMI Wakako,FUKUTA Seiko,OKUDA Shinichi,DOI Masahiro,WADA Yasuaki,NAO Tomoko,YAMADA Jutaro,OKAMURA Takayuki,YANO Masafumi,MATSUZAKI Masunori
Circulation journal : official journal of the Japanese Circulation Society 76(7), 1646-1653, 2012-06-25
… pulmonary capillary wedge pressure [PCWP], 26±8mmHg) were enrolled in this study. … Low-dose landiolol (1.5μg·kg-1·min-1) significantly reduced HR by 11% without changing blood pressure (BP) and CI, whereas higher doses (≥3.0μg·kg-1·min-1) tended to decrease BP and CI while increasing PCWP and systemic vascular resistance. …
NAID 10030503344

Tissue Doppler Imaging-Derived Myocardial Acceleration During Isovolumetric Contraction Predicts Pulmonary Capillary Wedge Pressure in Patients With Reduced Ejection Fraction

OMAR Alaa Mabrouk Salem,TANAKA Hidekazu,MATSUMOTO Kensuke,TATSUMI Kazuhiro,MIYOSHI Tatsuya,HIRAISHI Mana,TSUJI Takayuki,KANEKO Akihiro,RYO Keiko,FUKUDA Yuko,KAWAI Hiroya,HIRATA Ken-ichi
Circulation journal : official journal of the Japanese Circulation Society 76(6), 1399-1408, 2012-05-25
… We hypothesized that IVA correlates with the pulmonary capillary wedge pressure (PCWP) in patients with reduced EF. …
NAID 10030316170