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

Wanjie Yang,¹ Xuefeng Zhao,¹ Qingguo Feng,¹ Youzhong An,² Kai Wei,¹ Wei Wang,¹ Chang Li,¹ Xiuling Cheng<sup>1

1</sup>Intensive Care Unit, the Fifth Central Hospital of Tianjin, Tianjin, People’s Republic of China; ²Intensive Care Unit, Peking University People’s Hospital, Beijing, People’s Republic of China

Objective: To accurately measure the end-expiratory pulmonary artery wedge pressure (PAWP) with the “expiration holding” function on the ventilator and the “pulmonary artery wedge pressure review” software on the monitor.
Materials and methods: Fifty prospective measurements were made on 12 patients undergoing pulmonary artery catheter and mechanical ventilation. All measurements were divided into <8 mmHg or ≥8 mmHg subgroups according to respiratory variability, and they were then subdivided into either an airway pressure display measurement group (AM group) or an expiration holding (EH) group for comparison.
Results: In all measurements, the two groups showed similar levels of accuracy; however, for the time spent for measurement, the EH group was much faster than the airway pressure display measurement group (P<0.001). Additionally, the EH group was associated with lower medical costs.
Conclusion: The expiration holding approach measured the PAWP more accurately, more quickly, and with reduced costs in comparison to the airway pressure display approach.

Keywords: expiration holding, pulmonary artery wedge pressure, eePAWP, mechanical ventilation, pulmonary artery catheter