• Anaesthesia · Feb 2012

    The accuracy of transoesophageal echocardiography in estimating pulmonary capillary wedge pressure in anaesthetised patients.

    • C F Royse, M M Ali, and K Connelly.
    • Anaesthesia and Pain Management Unit, Department of Pharmacology, The University of Melbourne, Australia.
    • Anaesthesia. 2012 Feb 1;67(2):122-31.

    AbstractThe objective of this study was to identify whether pulmonary capillary wedge pressure can be estimated in anaesthetised patients receiving mechanical ventilation, using transoesophageal echocardiography. A retrospective validation study investigated a 10-patient cohort with variable haemodynamic conditions, and a 102-patient series in which a single measurement was made during stable haemodynamic conditions. Concurrent echocardiographic Doppler and pulmonary artery catheter wedge pressure measurements were performed. In the 10-patient cohort, the systolic fraction of Doppler measurements in the pulmonary vein (r = -0.32, p = 0.035) and the E/A ratio (r = 0.56, p = 0.0009) were correlated with the wedge pressure. In all cases, the limits of agreement exceeded 10 mmHg, and sensitivity or specificity for detecting wedge pressure ≥ 15 mmHg was poor. This study demonstrates proof of concept that using transoesophageal echocardiography for estimating the pulmonary artery wedge pressure may not be sufficiently accurate for clinical use.Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

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