Pulmonary Artery Pressure Monitoring in Acute Burn Management

Abstract

Pulmonary artery pressure (PAP) was measured for two to five days in ten patients with extensive burns. The PAP is low immediately after burn and rises during fluid resuscitation. The PA systolic pressure, 25 to 40 mm Hg during resuscitation of most burn patients, correlates with pulmonary vascular resistance and interstitial pulmonary fluid. The PA diastolic pressure, 10 to 20 mm Hg during burn resuscitation, correlates with left atrial pressure, hence left ventricular function. Higher levels indicate fluid overload. Some patients with smoke inhalation damage may develop gross pulmonary edema with normal PA diastolic pressure. Pulmonary artery pressure is a much more sensitive indicator of blood volume, cardiac function, and smoke-induced pulmonary edema than central venous pressure.