Noninvasrve estimation of paop during mechanical ventilatory support in critically ill adults

Introduction: At a time when there is renewed controversy about the use of flow-directed balloon-tipped pulmonary artery catheters and increasing hesitation in their use, the ability to estimate the PAOP nomnvasively is welcome. Methods: Twenty mechanically ventilated, critically ill adults with flowdirected, balloon-tipped pulmonary artery catheters were recruited to evaluate a nomnvasive device (VenCor, CVP Diagnostics, Laguna Beach CA) estimates PAOP based on the pulse pressure response to Valsalva as measured by finger plethysmography. Results: Twenty subjects (8 men, 12 women) ranging in age from 49 to 89 years (median- 61 ), had first day APACHE III acute physiology scores that ranged from 24 to 92 (median= 52 ). The PAOP measures ranged from 9 to 24 mm Hg. There is no significant difference (paired t - -0.91, df = 19, p>.05) between the two measures and they are significantly correlated (r=.90, p<.05) with each other. Conclusions: The VeriCor provides the means to estimate PAOP noninvasively.