• T S Ahrens and L Schallom.
• Critical Care Units, Barnes-Jewish Hospital, One Barnes Hospital Plaza, St Louis, MO 63110, USA.
• Heart Lung. 2001 Jan 1; 30 (1): 26-38.

BackgroundTechniques to measure pulmonary artery (PA) pressure waveforms include digital measurement, graphic measurement, and freeze-cursor measurement. Previous studies reported the inaccuracy of digital and freeze-cursor measurements. However, many of the previous studies were small and did not thoroughly examine the circumstances of when digital measurements might be inaccurate.ObjectivesTo compare digital measurements and graphic measurements of PA and central venous pressure (CVP) waveforms in patients with a variety of respiratory patterns, and to compare digital measurements and graphic measurements of CVPs in patients with abnormal or right ventricular waveforms.MethodsA total of 928 patients were enrolled in this study. Waveforms from the PA and CVP were collected from each patient. The monitor pressure value (digital measurement) printed on the recorded waveform was compared with the pressure value obtained by a graphic strip recording and measured by one of the primary investigators (graphic measurement).ResultsDigital measurements were found to be inaccurate in measuring waveforms in all respiratory categories and in measuring right ventricular waveforms. PA diastolic values and CVP values were the most inaccurately measured waveforms. Digital errors of more than 4 mm Hg were common.ConclusionThere were instances in which the monitor's digital measurement was substantially different from the graphically measured value. This difference has the potential to mislead interpretation of clinical situations. The monitor's ability to occasionally give digital measurement values similar to the graphic measurements may lead to a false sense of security in clinicians. Because the accuracy of the monitor is inconsistent, the bedside clinician should interpret waveforms through use of a graphic recording rather than rely on the digital measurement on the monitor.

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