Vignon et al used transesophageal echocardiography to determine the pulmonary artery occlusion pressure (PAOP) in a patient receiving mechanical ventilation. The authors are from Dupuytren Teaching Hospital, University of Limoges, Jean Bernard Teaching Hospital and Teaching Hospital (Clermont-Ferrand) in France.


Patient selection: mechanical ventilation with shock and/or respiratory failure


Method: Doppler tissue imaging (DTI) during transesophageal echocardiography with color M-mode


Goal: prediction of a PAOP <= 18 mm Hg



(1) E = mitral E wave velocity, in cm/s

(2) E' = early diastolic velocity, in cm/s

(3) Vp = propagation velocity of early diastolic blood flow within the left ventricle, in cm/s


Parameters diagnostic of the target PAOP (specificity 100%):

(1) E/Vp ratio (from DTI lateral mitral ring) <= 1.7


Parameter associated with target PAOP (specificity 88%):

(1) lateral E to E' ratio (from color M-mode propagation velocity) <= 8.0


According to Table 5, a PAOP > 18 mm Hg was associated with:

(1) E to E' lateral ratio >= 10.6

(2) E/Vp ratio >= 3.0


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