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Chest, Vol 80, 666-670, Copyright © 1981 by American College of Chest Physicians

ARTICLES

Swan-Ganz catheter location and left atrial pressure determine the accuracy of the wedge pressure when positive end-expiratory pressure is used

DM Shasby, IM Dauber, S Pfister, JT Anderson, SB Carson, F Manart and TM Hyers

In 43 percent of 30 consecutive open heart surgery patients, Swan-Ganz catheter tips lodged within 1 cm of or above the left atrium. When in this position the wedge pressure measured by the catheter was not an accurate estimate of left atrial pressure when positive end-expiratory pressure (PEEP) was used, especially when left atrial pressure was low. Catheters located below the left atrium were accurate at all levels of PEEP tested. The position of Swan-Ganz catheters should be confirmed by a lateral chest roentgenogram when PEEP is used, and catheter tips not below the left atrium should be repositioned.


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