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
- of or relating to hair
- a tube of small internal diameter; holds liquid by capillary action (同)capillary tube, capillary tubing
- any of the minute blood vessels connecting arterioles with venules (同)capillary_vessel
- long and slender with a very small internal diameter; "a capillary tube" (同)hairlike
- 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》
- 毛状の,毛のように細い / 毛細管の / 毛細管
- …‘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)』「2016/03/21 19:03:31」(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
- Noninvasive cardiac output measurement by inert gas rebreathing in suspected pulmonary hypertension.
- Farina S1, Teruzzi G1, Cattadori G1, Ferrari C1, De Martini S1, Bussotti M2, Calligaris G1, Bartorelli A3, Agostoni P4.Author information 1Centro Cardiologico Monzino, IRCCS, Milan, Italy.2Cardiologia Riabilitativa, Fondazione S. Maugeri, IRCCS, Milan, Italy.3Centro Cardiologico Monzino, IRCCS, Milan, Italy; Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.4Centro Cardiologico Monzino, IRCCS, Milan, Italy; Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington. Electronic address: piergiuseppe.agostoni@ccfm.it.AbstractThe objective of this study was to evaluate inert gas rebreathing (IGR) reliability in cardiac output (CO) measurement compared with Fick method and thermodilution. IGR is a noninvasive method for CO measurement; CO by IGR is calculated as pulmonary blood flow plus intrapulmonary shunt. IGR may be ideal for follow-up of patients with pulmonary hypertension (PH), sparing the need of repeated invasive right-sided cardiac catheterization. Right-sided cardiac catheterization with CO measurement by thermodilution, Fick method, and IGR was performed in 125 patients with possible PH by echocardiography. Patients were grouped according to right-sided cardiac catheterization-measured mean pulmonary and wedge pressures: normal pulmonary arterial pressure (n = 20, mean pulmonary arterial pressure = 18 ± 3 mm Hg, pulmonary capillary wedge pressure = 11 ± 5 mm Hg), PH and normal pulmonary capillary wedge pressure (PH-NW, n = 37 mean pulmonary arterial pressure = 42 ± 13 mm Hg, pulmonary capillary wedge pressure = 11 ± 6 mm Hg), and PH and high pulmonary capillary wedge pressure (PH-HW, n = 68, mean pulmonary arterial pressure = 37 ± 9 mm Hg, pulmonary capillary wedge pressure = 24 ± 6 mm Hg). Thermodilution and Fick measurements were comparable. Fick and IGR agreement was observed in normal pulmonary arterial pressure (CO = 4.10 ± 1.14 and 4.08 ± 0.97 L/min, respectively), whereas IGR overestimated Fick in patients with PH-NW and those with PH-HW because of intrapulmonary shunting overestimation in hypoxemic patients. When patients with arterial oxygen saturation (SO2) ≤90% were excluded, IGR and Fick agreement improved in PH-NW (CO = 4.90 ± 1.70 and 4.76 ± 1.35 L/min, respectively) and PH-HW (CO = 4.05 ± 1.04 and 4.10 ± 1.17 L/min, respectively). In hypoxemic patients, we estimated pulmonary shunt as Fick - pulmonary blood flow and calculated shunt as: -0.2423 × arterial SO2 + 21.373 L/min. In conclusion, IGR is reliable for CO measurement in patients with PH with arterial SO2 >90%. For patients with arterial SO2 ≤90%, a new formula for shunt calculation is proposed.
- The American journal of cardiology.Am J Cardiol.2014 Feb 1;113(3):546-51. doi: 10.1016/j.amjcard.2013.10.017. Epub 2013 Nov 7.
- The objective of this study was to evaluate inert gas rebreathing (IGR) reliability in cardiac output (CO) measurement compared with Fick method and thermodilution. IGR is a noninvasive method for CO measurement; CO by IGR is calculated as pulmonary blood flow plus intrapulmonary shunt. IGR may be i
- PMID 24315114
- Prevalence and Risk Factors for Pulmonary Arterial Hypertension in a Large Group of β-Thalassemia Patients Using Right Heart Catheterization: A Webthal Study.
- Derchi G, Galanello R, Bina P, Cappellini MD, Piga A, Lai ME, Quarta A, Casu G, Perrotta S, Pinto V, Musallam KM, Forni GL; Webthal Pulmonary Arterial Hypertension Group*.Author information Galliera Hospital, Genoa, Italy (G.D., V.P., G.L.F.); University of Cagliari, Cagliari, Italy (R.G., P.B., M.-E.L.); IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, University of Milan, Milan, Italy (M.D.C., K.M.M.); University of Turin, Turin, Italy (A.P.); Perrino Hospital, Brindisi, Italy (A.Q.); S. Francesco Hospital, Nuoro, Italy (G.C.); and Seconda University, Naples, Italy (S.P.).AbstractBACKGROUND: Pulmonary arterial hypertension (PAH) remains a concern in patients with β-thalassemia major (TM) and intermedia (TI); however, studies evaluating its prevalence and risk factors using systematic confirmation on right heart catheterization are lacking.
- Circulation.Circulation.2014 Jan 21;129(3):338-45. doi: 10.1161/CIRCULATIONAHA.113.002124. Epub 2013 Sep 30.
- BACKGROUND: Pulmonary arterial hypertension (PAH) remains a concern in patients with β-thalassemia major (TM) and intermedia (TI); however, studies evaluating its prevalence and risk factors using systematic confirmation on right heart catheterization are lacking.METHODS AND RESULTS: This was a mul
- PMID 24081970
- Extravascular lung water and pulmonary arterial wedge pressure for fluid management in patients with acute respiratory distress syndrome.
- Hu W, Lin CW, Liu BW, Hu WH, Zhu Y.AbstractBACKGROUND: Extravascular lung water (EVLW) is a sensitive prognostic indicator of pulmonary edema. Thus, EVLW may be an advantageous method of fluid management. This study aims to evaluate the outcomes of using EVLW and pulmonary artery wedge pressure (PAWP) as strategies for fluid management in patients with acute respiratory distress syndrome (ARDS).
- Multidisciplinary respiratory medicine.Multidiscip Respir Med.2014 Jan 16;9(1):3. [Epub ahead of print]
- BACKGROUND: Extravascular lung water (EVLW) is a sensitive prognostic indicator of pulmonary edema. Thus, EVLW may be an advantageous method of fluid management. This study aims to evaluate the outcomes of using EVLW and pulmonary artery wedge pressure (PAWP) as strategies for fluid management in pa
- PMID 24428957
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
- Combination Evaluation of Preoperative Risk Indices Predicts Requirement of Biventricular Assist Device
- SHIGA Taro,KINUGAWA Koichiro,IMAMURA Teruhiko,KATO Naoko,ENDO Miyoko,INABA Toshiro,MAKI Hisataka,HATANO Masaru,YAO Atsushi,NISHIMURA Takashi,HIRATA Yasunobu,KYO Shunei,ONO Minoru,NAGAI Ryozo
- Circulation journal : official journal of the Japanese Circulation Society 76(12), 2785-2791, 2012-11-25
- … Preoperative central venous pressure (CVP)/pulmonary capillary wedge pressure (PCWP) ratio ≥0.5 (OR, 13.09; …
- NAID 10031126049
- 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<sup>-1</sup>·min<sup>-1</sup>) significantly reduced HR by 11% without changing blood pressure (BP) and CI, whereas higher doses (≥3.0μg·kg<sup>-1</sup>·min<sup>-1</sup>) tended to decrease BP and CI while increasing PCWP and systemic vascular resistance. …
- NAID 10030503344
Related Links
- The pulmonary capillary wedge pressure or PCWP (also called the pulmonary wedge pressure or PWP, or pulmonary artery occlusion pressure or PAOP) is the pressure measured by wedging a pulmonary catheter with an inflated balloon into ...
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
[★]
- 英
- pulmonary capillary pressure
- 関
- 肺動脈楔入圧、pulmonary capillary wedge pressure、PCWP
[★]
[★]
[★]
- 関
- lung、pneumo
[★]
[★]
毛細血管