Patient Monitor User Manual Monitoring IBP
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14.6 Measuring PAWP
PAWP, Pulmonary Artery Wedge Pressure, used to assess the cardiac function, is obtained by
introducing a balloon-tipped pulmonary artery flotation catheter into the pulmonary artery. When
the catheter is in one of the smaller pulmonary arteries, the inflated balloon occludes the artery
allowing the monitor to record changes in the intrathoracic pressures that occur throughout the
respiration cycle. The user can view the PAWP measurement result via connected CMS.
14.6.1 Measurement Procedures
Pulmonary Artery Wedge Pressure (PAWP) values are affected by fluid status, myocardial
contractility, valve and pulmonary circulation integrity. The most accurate PAWP values are
obtained at the end of the respiration cycle when the intrathoracic pressure is fairly constant. You
can use the respiration waveform as a reference when assessing the PAWP waveform, to ensure
constant measurement timing relative to the respiratory cycle.
To start the measurement:
1. On the standard screen interface, select the PA parameter window to enter its setup menu.
Then, select Setup > PAWP Activate to open the PAWP measurement window.
2. Prepare and check the accessories according to your hospital policy.
3. Wedge the flotation catheter into the pulmonary artery. Then inflate the balloon and pay
attention to PA waveform changes on the screen.
4. After obtaining a stable PAWP waveform, press Freeze to freeze the waveform. In freeze
status, you can adjust the PAWP scale to an appropriate position by selecting Measure and
moving the cursors up and down according to the clinical experience. Select Confirm to
store the PAWP, CVP, HR values. To review the frozen waveform, press Browse and rotate
the rotary knob clockwise or counter-clockwise as desired. If you need to review the stored
PAWP, CVP, HR values, select PAWP Review.
5. Deflate the balloon when the monitor prompts you “Please deflate the balloon!”.
6. If you need to start a new measurement, select Remeasure.
7. Click on Exit or select Setup > PAWP Exit to exit.
WARNING
1 Prolonged inflation can cause pulmonary hemorrhage, infarction or both. Inflate the
balloon for the minimum time necessary to get an accurate measurement.
2 If the PAWP (mean) is greater than the PA (systolic), deflate the balloon and report
the incident in accordance with hospital policy, because the pulmonary artery could
be accidently ruptured, and the PAWP value derived will not reflect the patient’s
hemodynamic state, but will merely reflect the pressure in the catheter or balloon.
3 The pressure receiver in the catheter records the pressure change that occurs only at
the front of the obstruction.
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