User's Manual

14 - 7
14.6.8 Setting the Use PA-D as PAWP Switch
The PA-D value can be configured to replace the PAWP value for hemodynamic calculation. To do so, follow this
procedure:
1. Select the PA numeric area or waveform area to enter the
PA dialog.
2. Select the
Setup tab.
3. Switch on or off
Use PA-D as PAWP.
For more information on hemodynamic calculation, see
20.4Hemodynamic Calculations.
14.6.9 Enabling PPV Measurement
PPV indicates pulse pressure variation. When measuring the arterial pressure (except PA), the PPV measurement
is available. To enable the PPV measurement, follow this procedure:
1. Select the IBP numeric area or waveform area to enter the corresponding pressure dialog.
2. Select the
PPV Setup tab.
3. Switch on
PPV Measure.
You can select PPV source after enabling the PPV measurement.
WARNING
• This monitor can calculate PPV from beat-to-beat values of any arterial pulsatile pressure. The
circumstances under which the calculation of a PPV value is clinically meaningful, appropriate and
reliable must be determined by a physician.
• The clinical value of the derived PPV information must be determined by a physician. According to
recent scientific literature, the clinical relevance of PPV information is restricted to sedated patients
receiving controlled mechanical ventilation and mainly free from cardiac arrhythmia.
• PPV calculation may lead to inaccurate values in the following situations:
◆ at respiration rates below 8 rpm
◆ during ventilation with tidal volumes lower than 8 ml/kg
◆ for patients with acute right ventricular dysfunction (cor pulmonale).
• The PPV measurement has been validated only for adult patients.
14.7 PAWP
Pulmonary Artery Wedge Pressure (PAWP) values, used to assess cardiac function, are affected by fluid status,
myocardial contractility, and valve and pulmonary circulation integrity.
Obtain the measurement 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 pulmonary wedge pressure is the left ventricular end diastolic pressure when the airway pressure and valve
function are normal. The most accurate PAWP values are obtained at the end of the respiration cycle when the
intrathoracic pressure is fairly constant and the artifact caused by respiration is minimal.
WARNING
• PAWP monitoring is not intended for neonatal patients.