肺動脈楔入圧 PAWP
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
- a major thoroughfare that bears important traffic
- a blood vessel that carries blood from the heart to the body (同)arteria, arterial blood vessel
- 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》
- 動脈 / (道路・水路・鉄道などの)勘線,(通信の)主チャンネル
- …‘と'結婚する,‘を'妻(夫)にする / 結婚する
- 肺の;肺を冒す
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2016/06/05 14:21:19」(JST)
[Wiki en表示]
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 |
diastolic |
3–8 |
Pulmonary artery pressure |
systolic |
15–30 |
diastolic |
4–12 |
Pulmonary vein/
Pulmonary capillary wedge pressure
|
2–15 |
Left ventricular pressure |
systolic |
100–140 |
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)
Physiology of the cardiovascular system
|
|
Heart |
Cardiac output |
- Cardiac cycle
- Cardiac output
- Stroke volume
- End-diastolic volume
- End-systolic volume
- Afterload
- Preload
- Frank–Starling law of the heart
- Cardiac function curve
- Venous return curve
- Wiggers diagram
- Pressure volume diagram
|
|
Ultrasound |
- Fractional shortening = (End-diastolic dimension
- End-systolic dimension) / End-diastolic dimension
- Aortic valve area calculation
- Ejection fraction
- Cardiac index
|
|
Heart rate |
- Cardiac pacemaker
- Chronotropic (Heart rate)
- Dromotropic (Conduction velocity)
- Inotropic (Contractility)
- Bathmotropic (Excitability)
- Lusitropic (Relaxation)
|
|
Conduction |
- Conduction system
- Cardiac electrophysiology
- Action potential
- cardiac
- atrial
- ventricular
- Effective refractory period
- Pacemaker potential
- Electrocardiography
- P wave
- PR interval
- QRS complex
- QT interval
- ST segment
- T wave
- U wave
- Hexaxial reference system
|
|
Chamber pressure |
- Central venous
- Right
- pulmonary artery
- Left
- Aortic
|
|
Other |
|
|
|
Vascular system/
Hemodynamics |
Blood flow |
- Compliance
- Vascular resistance
- Pulse
- Perfusion
|
|
Blood pressure |
- Pulse pressure
- Mean arterial pressure
- Jugular venous pressure
- Portal venous pressure
|
|
Regulation of BP |
- Baroreflex
- Kinin–kallikrein system
- Renin–angiotensin system
- Vasoconstrictors
- Vasodilators
- Autoregulation
- Myogenic mechanism
- Tubuloglomerular feedback
- Cerebral autoregulation
- Paraganglia
- Aortic body
- Carotid body
- Glomus cell
|
|
|
UpToDate Contents
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English Journal
- The effects of oxygen induced pulmonary vasoconstriction on bedside measurement of pulmonary gas exchange.
- Weinreich UM1, Thomsen LP, Rees SE, Rasmussen BS.
- Journal of clinical monitoring and computing.J Clin Monit Comput.2015 May 12. [Epub ahead of print]
- In patients with respiratory failure measurements of pulmonary gas exchange are of importance. The bedside automatic lung parameter estimator (ALPE) of pulmonary gas exchange is based on changes in inspired oxygen (FiO2) assuming that these changes do not affect pulmonary circulation. This assumptio
- PMID 25962614
- Pulmonary congestion at rest and abnormal ventilation during exercise in chronic systolic heart failure.
- Malfatto G1, Caravita S2, Giglio A1, Rossi J1, Perego GB1, Facchini M1, Parati G2.
- Journal of the American Heart Association.J Am Heart Assoc.2015 May 5;4(5). pii: e001678. doi: 10.1161/JAHA.114.001678.
- BACKGROUND: In patients with chronic heart failure, abnormal ventilation at cardiopulmonary testing (expressed by minute ventilation-to-carbon dioxide production, or VE/VCO2 slope, and resting end-tidal CO2 pressure) may derive either from abnormal autonomic or chemoreflex regulation or from lung dy
- PMID 25944875
- Tissue Doppler-Derived Myocardial Acceleration during Isovolumetric Contraction Predicts Pulmonary Capillary Wedge Pressure in Patients with Significant Mitral Regurgitation.
- Omar AM1, Abdel-Rahman MA2, Khorshid H2, Helmy M2, Raslan H3, Rifaie O2.
- Ultrasound in medicine & biology.Ultrasound Med Biol.2015 May 2. pii: S0301-5629(15)00270-7. doi: 10.1016/j.ultrasmedbio.2015.03.031. [Epub ahead of print]
- The aim of this study was to determine whether isovolumic contraction velocity (IVV) and acceleration (IVA) predict pulmonary capillary wedge pressure (PCWP) in mitral regurgitation. Forty-four patients with mitral regurgitation were studied. PCWP was invasively measured. IVV, IVA and the ratio IVRT
- PMID 25944284
Japanese Journal
- 眼科手術後に心肺停止状態となり,神経原性肺水腫が疑われた一例
- 伊佐 泰樹,原山 信也,荒井 秀明,長田 圭司,新庄 貴文,二瓶 俊一,相原 啓二,蒲地 正幸
- 日本集中治療医学会雑誌 20(2), 243-246, 2013
- 【はじめに】くも膜下出血,頭部外傷,てんかんなど中枢神経系障害の後に神経原性肺水腫をきたすことが知られているが,脳梗塞が原因とされる報告は少ない。脳梗塞を原因とする神経原性肺水腫と考えられた症例を経験したので報告する。【症例】54歳,女性。緑内障の手術のため入院し,全身麻酔下で濾過手術を施行,術後抜管され病棟へ帰室した。帰室後呼吸苦を訴え心肺停止となり,心肺蘇生を行い18分後に心拍が再開した。胸部 …
- NAID 130004514513
- 福本 義弘
- 臨床薬理 43(5), 311-315, 2012
- … Post-capillary pulmonary hypertension (pc-PH) is defined as mean pulmonary arterial pressure≥25 mmHg and mean pulmonary capillary wedge pressure>15 mmHg, and is classified into 2 types depending on the status of pulmonary vascular resistance (PVR) or trans-pulmonary pressure gradient (TPG) : reactive pc-PH with elevated PVR (>2. …
- NAID 130004541477
- Relation Between Connective Tissue Growth Factor and Cardiac Sympathetic Nerve Activity in Heart Failure in DCM Patients
- , , , , , , , , , ,
- International Heart Journal 53(5), 282-286, 2012
- … Moreover, a higher NYHA class and pulmonary artery wedge pressure were associated with a higher plasma CTGF level. …
- NAID 130001914163
Related Links
- Definition of pulmonary artery wedge pressure in the Medical Dictionary. pulmonary artery wedge pressure explanation. Information about pulmonary artery wedge pressure in Free online English dictionary. What is pulmonary ...
- Pulmonary Artery Wedge Pressure is the pressure measured by wedging a pulmonary catheter with an inflated balloon into a small pulmonary arterial branch. It provides ... What is Pulmonary artery wedge pressure? An indirect ...
Related Pictures
★リンクテーブル★
[★]
- wedge
- 日
- けつにゅうあつ
- 英
- pulmonary arterial wedge pressure, PAWP, pulmonary artery wedge pressure
- 同
- 肺毛細血管楔入圧 pulmonary capillary wedge pressure PCWP PCW
基準範囲
- 4.5-13mmHg (臨床検査法提要第32版 p.1574)
- 正常値は2~15(平均9)mmHg。
臨床徴候との関連
- スワン-ガンツ・カテーテルで肺動脈の枝を閉塞したときに、そのカテーテル末端で測定される血圧。
- 拡張期左室圧を推定できる ← 拡張期には僧帽弁は開放されており、 左室圧 = 左房圧 = pulmonary venous bedの圧力
- 左心系前負荷である左房圧を反映するため、左室の前負荷状態の指標として有用
疾患との関連
左室不全と右室不全 LAB.1573
- 左室不全:左室拡張末期圧12mmHg以上(肺動脈楔入圧13Hg以上)かつ心係数2.71/分/m2以下
- 右室不全:右室拡張末期圧 5mmHg以下 かつ心係数2.71/分/m2以下
[★]
- 関
- pulmonary artery wedge pressure、pulmonary capillary wedge pressure、wedge pressure
[★]
[★]
- 関
- lung、pneumo
[★]