Abstract

YEPES, D.; BEJARANO, J.; PANESSO, R.  and  GRANADOS, M.. Non-invasive evaluation of pulmonary artery occlusion pressure in critically ill patients with mechanical ventilation. Med. Intensiva [online]. 2007, vol.31, n.7, pp.361-366. ISSN 0210-5691.

Objective. To compare the measurements of pulmonary artery occlusion pressure (PAOP) by means of the use a pulmonary artery catheter and those obtained through a formula that relates the systolic artery pressure before and after a Valsalva maneuver. Design. Prospective observational study. Scope. Medical-surgical intensive care unit. Patients. A total of 120 patients mechanically ventilated and with deep sedation who had pulmonary artery catheter and arterial line.  Interventions. Provocation of a Valsalva maneuver by maintaining airway pressure at 30 mmHg for 10 seconds that was subsequently released.  Main variables of interest. PAOP measured at the end of expiration by means of the use of a pulmonary artery catheter, PAOP was calculated by means of the use of a formula that relates the systolic artery pressure before and after a Valsalva maneuver. Results. There was a limited correlation between the measured PAOP and that calculated by means of the Valsalva maneuver in the total population (r = 0.44, CI 95%: 0.28 to 0.57, p = 0.0001). There was a better correlation in the post-surgical subgroup (r = 0.518, CI 95%: 0.1055 to 0.7738, p = 0.016) and in the sub-group of «Others diagnosis» (r = 0.62, CI: 95%: 0.30 to 0.81, p = 0.001). Conclusions. The prediction of the PAOP by means of the Valsalva maneuver showed a limited correlation with that obtained by means of the pulmonary artery catheter.

Keywords : critical care; mechanical ventilation; pulmonary artery catheter; pulmonary occlusion pressure; Valsalva maneuver.