par De Backer, Daniel 
Référence Advanced Hemodynamic Monitoring: Basics and New Horizons, Springer International Publishing, page (31-37)
Publication Publié, 2021-01
Référence Advanced Hemodynamic Monitoring: Basics and New Horizons, Springer International Publishing, page (31-37)
Publication Publié, 2021-01
Partie d'ouvrage collectif
| Résumé : | There is a long-time interest for measuring pulmonary pressures which include the pulmonary artery pressure (PAP) and the pulmonary artery occlusion pressure (PAOP). It is important to understand the physiological role of these variables in cardiovascular and pulmonary medicine. Even if the use of pulmonary artery catheter has decreased, the interest for PAP and PAOP remain, especially as these can also be reliably estimated with echocardiography. The PAP is the back pressure of the right ventricle, and is therefore an important determinant of its afterload. Measuring PAP is important for the identification of the cause of right ventricular dysfunction as well as for its management. PAOP reflects left ventricular preload, and hence an important contributor of cardiac output. An elevated PAOP also contributes to pulmonary edema. It is a key determinant of capillary leak, together with vascular permeability. PAOP, as any other “static” measurement of preload, does not optimally predict fluid responsiveness, even though extreme values keep some value. Importantly, PAOP can be used as a safety measure during fluid challenge. In this chapter, we will discuss the physiology of pulmonary pressures, their determinants, their measurements, and their potential use in cardiovascular medicine and critical care. |
