Okay so I am not totally lazy. I attempted to research this question before posting but could not find any literature that breaks this down in lamens terms. Can anyone explain the concept of "end-expiration" when obtaining a wedge pressure in a non-ventilated vs ventilated patient and also how this relates to ventilated patients receiving "peep"? And also when you obtain the wedge reading, what exactly are you measuring on the monitor? I understand the concept of wedging, how it measures preload in the LV, and how the balloon inflates in the pulmonary artery (occluding it so to speak) and a pressure reading is obtained, but I am still a little confused about what I am looking at when obtaining the wedge waveform, and how the measurement is actually obtained. I am a fairly new critical care nurse and am just trying to put all the peices together.
okay so i had a lecture today at work that finally made it all clear for me. The answer was so simple. If the patient is spontaneously breathing, you measure the wedge at the peak of the wave form which represents end-expiration, and if the patient is mechanically ventilated, end-expiration is measured at the valley of the waveform. It seems silly now that i didnt understand it, but i guess i just needed it to be drawn out for me. i understand the "peep" aspect of it also now. thanks again to everyone who responded!
LeLeeFNP
230 Posts
okay so i had a lecture today at work that finally made it all clear for me. The answer was so simple. If the patient is spontaneously breathing, you measure the wedge at the peak of the wave form which represents end-expiration, and if the patient is mechanically ventilated, end-expiration is measured at the valley of the waveform. It seems silly now that i didnt understand it, but i guess i just needed it to be drawn out for me. i understand the "peep" aspect of it also now. thanks again to everyone who responded!