Reliability of Central Venous Pressure as an Indicator of Left Atrial Pressure

CHEST Journal ◽  
1971 ◽  
Vol 59 (2) ◽  
pp. 169-173 ◽  
Author(s):  
Hubert Bell ◽  
David Stubbs ◽  
David Pugh
Keyword(s):  
Central Venous Pressure ◽  
Left Atrial ◽  
Venous Pressure ◽  
Atrial Pressure ◽  
Left Atrial Pressure ◽  
Central Venous

Effect of thoracic duct drainage on hydrostatic pulmonary edema and pleural effusion in sheep

1991 ◽  
Vol 71 (1) ◽  
pp. 314-316 ◽  
Author(s):  
S. J. Allen ◽  
R. E. Drake ◽  
G. A. Laine ◽  
J. C. Gabel
Keyword(s):  
Pleural Effusion ◽  
Central Venous Pressure ◽  
Pulmonary Edema ◽  
Thoracic Duct ◽  
Left Atrial ◽  
Venous Pressure ◽  
Atrial Pressure ◽  
Left Atrial Pressure ◽  
Central Venous ◽  
Pulmonary Arterial

Positive end-expiratory pressure (PEEP) increases central venous pressure, which in turn impedes return of systemic and pulmonary lymph, thereby favoring formation of pulmonary edema with increased microvascular pressure. In these experiments we examined the effect of thoracic duct drainage on pulmonary edema and hydrothorax associated with PEEP and increased left atrial pressure in unanesthetized sheep. The sheep were connected via a tracheostomy to a ventilator that supplied 20 Torr PEEP. By inflation of a previously inserted intracardiac balloon, left atrial pressure was increased to 35 mmHg for 3 h. Pulmonary arterial, systemic arterial, and central venous pressure as well as thoracic duct lymph flow rate were continuously monitored, and the findings were compared with those in sheep without thoracic duct cannulation (controls). At the end of the experiment we determined the severity of pulmonary edema and the volume of pleural effusion. With PEEP and left atrial balloon insufflation, central venous and pulmonary arterial pressure were increased approximately threefold (P less than 0.05). In sheep with a thoracic duct fistula, pulmonary edema was less (extra-vascular fluid-to-blood-free dry weight ratio 4.8 +/- 1.0 vs. 6.1 +/- 1.0; P less than 0.05), and the volume of pleural effusion was reduced (2.0 +/- 2.9 vs. 11.3 +/- 9.6 ml; P less than 0.05). Our data signify that, in the presence of increased pulmonary microvascular pressure and PEEP, thoracic duct drainage reduces pulmonary edema and hydrothorax.

scholarly journals Central venous pressure from common iliac vein reflects right atrial pressure

1998 ◽  
Vol 45 (8) ◽  
pp. 798-801 ◽  
Author(s):  
Abdulaziz Alzeer ◽  
Subhash Arora ◽  
Ziauddin Ansari ◽  
Desouky F. Fayed ◽  
Mohamed Naguib
Keyword(s):  
Central Venous Pressure ◽  
Venous Pressure ◽  
Iliac Vein ◽  
Atrial Pressure ◽  
Right Atrial ◽  
Right Atrial Pressure ◽  
Common Iliac Vein ◽  
Central Venous

Elevation of superior vena caval pressure increases extravascular lung water after endotoxemia

1987 ◽  
Vol 62 (3) ◽  
pp. 1006-1009 ◽  
Author(s):  
S. J. Allen ◽  
R. E. Drake ◽  
J. Katz ◽  
J. C. Gabel ◽  
G. A. Laine
Keyword(s):  
Pulmonary Hypertension ◽  
Central Venous Pressure ◽  
Pulmonary Edema ◽  
Left Atrial ◽  
Superior Vena ◽  
Venous Pressure ◽  
Weight Ratio ◽  
Central Venous ◽  
Superior Vena Caval ◽  
Extravascular Fluid

In many sheep Escherichia coli endotoxin results in pulmonary hypertension, increased microvascular permeability, pulmonary edema, and increased central venous pressure. Since lung lymph drains into the systemic veins, increases in venous pressure may impair lymph flow sufficiently to enhance the accumulation of extravascular fluid. We tested the hypothesis that, following endotoxin, elevating the venous pressure would increase extravascular fluid. Thirteen sheep were chronically instrumented with catheters to monitor left atrial pressure (LAP), pulmonary arterial pressure (PAP), and superior vena caval pressure (SVCP) as well as balloons to elevate LAP and SVCP. These sheep received 4 micrograms/kg endotoxin, and following the pulmonary hypertensive spike the left atrial balloon was inflated so that (PAP + LAP)/2 = colloid osmotic pressure. It was necessary to control PAP + LAP in this way to minimize the sheep-to-sheep differences in the pulmonary hypertension. We elevated the SVCP to 10 or 17 mmHg or allowed it to stay low (3.2 mmHg). After a 3-h period, we killed the sheep and removed the right lungs for determination of the extravascular fluid-to-blood-free dry weight ratio (EVF). Sheep with SVCP elevated to 10 or 17 mmHg had significant increases in EVF (5.2 +/- 0.1 and 5.6 +/- 1.2) compared with the sheep in which we did not elevate SVCP (EVF = 4.5 +/- 0.4). These results indicate that sustained elevation in central venous pressure in patients contributes to the amount of pulmonary edema associated with endotoxemia.

Atrial distension in humans during microgravity induced by parabolic flights

1997 ◽  
Vol 83 (6) ◽  
pp. 1862-1866 ◽  
Author(s):  
Regitze Videbaek ◽  
Peter Norsk
Keyword(s):  
Central Venous Pressure ◽  
Left Atrium ◽  
Supine Position ◽  
Left Atrial ◽  
Venous Pressure ◽  
Esophageal Pressure ◽  
Central Venous ◽  
Parabolic Flights ◽  
Left Atrial Diameter ◽  
Cardiac Filling

Videbaek, Regitze, and Peter Norsk. Atrial distension in humans during microgravity induced by parabolic flights. J. Appl. Physiol. 83(6): 1862–1866, 1997.—The hypothesis was tested that human cardiac filling pressures increase and the left atrium is distended during 20-s periods of microgravity (μG) created by parabolic flights, compared with values of the 1-G supine position. Left atrial diameter ( n = 8, echocardiography) increased significantly during μG from 26.8 ± 1.2 to 30.4 ± 0.7 mm ( P < 0.05). Simultaneously, central venous pressure (CVP; n = 6, transducer-tipped catheter) decreased from 5.8 ± 1.5 to 4.5 ± 1.1 mmHg ( P < 0.05), and esophageal pressure (EP; n = 6) decreased from 1.5 ± 1.6 to −4.1 ± 1.7 mmHg ( P < 0.05). Thus transmural CVP (TCVP = CVP − EP; n = 4) increased during μG from 6.1 ± 3.2 to 10.4 ± 2.7 mmHg ( P < 0.05). It is concluded that short periods of μG during parabolic flights induce an increase in TCVP and left atrial diameter in humans, compared with the results obtained in the 1-G horizontal supine position, despite a decrease in CVP.

Wedge pressure in large vs. small pulmonary arteries to detect pulmonary venoconstriction

1985 ◽  
Vol 59 (4) ◽  
pp. 1329-1332 ◽  
Author(s):  
A. Zidulka ◽  
T. S. Hakim
Keyword(s):  
Blood Flow ◽  
Left Atrial ◽  
Venous Pressure ◽  
Pulmonary Veins ◽  
Atrial Pressure ◽  
Left Atrial Pressure ◽  
Large Artery ◽  
Small Artery ◽  
Proximal Site ◽  
Wedge Pressure

Pulmonary arterial wedge pressure measures the pressure where blood flow resumes on the venous side. By occlusion of a large artery, the point where blood flow resumes will be in or near the left atrium. However, by occlusion of a small artery, it is possible to shift the point where flow resumes to a more proximal site in the veins and thus measure a pressure within the small veins. Increased pulmonary venous pressure, as a result of partial obstruction in the large veins, may not be detected by wedging a Swan-Ganz catheter in a large artery but may be detected by wedging in a small artery. We demonstrated this phenomenon in open-chest dogs by mechanically obstructing the left lower lobar vein or by infusing histamine to cause a generalized pulmonary venoconstriction. The wedge pressure measured by a 7-F Swan-Ganz catheter, with its balloon inflated in the main left lower lobar artery, nearly equaled left atrial pressure. On the other hand, the wedge pressure measured with a 7-F, 5-F, or a PE-50 catheter advanced into a small artery (without a balloon) was considerably higher than left atrial pressure. These results suggest that high resistance in the pulmonary veins can be demonstrated with the Swan-Ganz catheter by comparing the pressures obtained with the catheter wedged in a small and large artery.

Pulmonary venous pressure: Relationship to pulmonary artery, pulmonary wedge, and left atrial pressure in normal, lightly sedated dogs

2002 ◽  
Vol 56 (3) ◽  
pp. 432-438 ◽  
Author(s):  
Hari P. Chaliki ◽  
David G. Hurrell ◽  
Rick A. Nishimura ◽  
Rebekah A. Reinke ◽  
Christopher P. Appleton
Keyword(s):  
Pulmonary Artery ◽  
Left Atrial ◽  
Venous Pressure ◽  
Atrial Pressure ◽  
Left Atrial Pressure
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