Advanced Haemodynamic Monitoring

The relationship of PAWP to left atrial pressure

The PAWP should be equivalent to the LA pressure. So, if the mitral valve is competent, the LA pressure should be equivalent to left ventricular end-diastolic pressure (and thus, to left ventricular preload - supposedly). This is only true for a catheter tip positioned in the most dependent portion of the lung (Wests Zone 3), where pulmonary arterial pressure is greater than alveolar air pressure (otherwise air pressure influences your measurement)

The relationship of CVP to right ventricular preload

In days gone by, people relied on the CVP as a simple means of predicting fluid responsiveness. But it turns out the CVP is really bad at predicting the patients' responsiveness to fluid challenges. There are too many variables governing central venous pressure. This has become evident from some high-quality evidence, and it has been known for some time. Indeed, so obvious the uselessness of CVP in this scenario, and so entrenched the practice of its use, that prominent authors have described a recent meta-analysis as a plea for common sense.


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