What is the role of left ventricular end-diastolic volume (LVEDV) in pulmonary artery catheterization (PAC)?

Updated: Dec 22, 2017
  • Author: Bojan Paunovic, MD; Chief Editor: Karlheinz Peter, MD, PhD  more...
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PCWP is a reflection of LAP, which, in the absence of mitral valve disease, is an indication of LV diastolic pressure. Often, the inference is made that PCWP reflects left ventricular end-diastolic volume (LVEDV) or end-diastolic pressure (LVEDP). Numerous conditions in critically ill patients preclude this assumption.

PCWP is the measurement by which changes in lung water (pulmonary capillary hydrostatic pressure [PCHP]) can be assessed. This concept holds true only if the resistance of the pulmonary venous system is assumed to be zero. In fact, the small pulmonary veins and capillaries account for approximately 40% of the total pulmonary vascular resistance. This value may be even higher in critically ill patients in whom pulmonary venoconstriction is common secondary to conditions such as hypoxemia and acute respiratory distress syndrome (ARDS). PCHP is always greater than PCWP. PCWP can be used to estimate the contribution of PCHP to lung edema if evidence of chronically elevated Ppv, permeability, pleural pressure, and osmotic pressure are considered.

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