Invasive Pressure Monitors: Leveling the Playing Field

• Published in: Journal of cardiothoracic and vascular anesthesia Vol. 37; no. 9; pp. 1793 - 1800
• Main Authors: Jerman, Catherine Foley, Baker, Keith H., Fitzsimons, Michael G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2023
• Subjects: arterial line; Arterial Pressure; Catheterization, Peripheral; Catheters, Indwelling; Central Venous Catheters; central venous pressure; Critical Care; external ventricular drain; Humans; leveling; lumbar drain; pulmonary artery catheter; pulmonary artery catheter; leveling; external ventricular drain; central venous pressure; arterial line; lumbar drain
• ISSN: 1053-0770; 1532-8422; 1532-8422
• DOI: 10.1053/j.jvca.2023.05.026

Invasive pressure monitors are ubiquitous in cardiothoracic and vascular anesthesia. This technology allows beat-to-beat assessment of central venous, pulmonary, and arterial blood pressures during surgery, procedural interventions, and critical care. Education is commonly focused on the procedural aspects and the complications associated with the initial placement of these monitors without instruction on the technical concepts required for obtaining accurate data. Anesthesiologists must understand the fundamental concepts on which measurements are made to effectively use invasive pressure monitors, including pulmonary artery catheters, central venous catheters, intra-arterial catheters, external ventricular drains, and spinal or lumbar drains. This review will address important gaps in knowledge surrounding leveling and zeroing of invasive pressure monitors, emphasizing the impact of varied practice patterns on patient care.