Non invasive assessment of pulmonary capillary wedge pressure using echocardiography.

Pulmonary capillary wedge pressure (Pw) is an important hemodynamic parameter frequently used in Intensive Care. Much effort was taken by investigators to noninvasively obtain this parameter particularly using echocardiography. The authors reviewed the published works in this field. There are a great number of correlations between echocardiographic variables and Pw, including equations for its precise assessment. Changes in echocardiographic parameters due to modifications in volume status and more recently tissue Doppler evaluation are also related fields. Despite the quality and quantity of investigation, no single method was established or accepted for non-invasive assessment of Pw using echocardiography. The major problems are related to the study of different populations regarding its basic clinical condition and to the complexity of equations described. Non-invasive assessment of Pw in clinical setting using echocardiography is still a hard task for this technique. Probably, the use of echocardiography as a non-invasive tool for hemodynamic assessment should use other methodologies, and not rely on Pw determination.