Pulmonary artery catheter: arterialisation of aspirated wedge blood confirms the wedge position in pulmonary hypertension

A falsely elevated pulmonary artery wedge pressure (PAWP) reading was obtained in a patient with pulmonary hypertension, despite compliance with accepted criteria for validation of the wedge position. The report suggests that in the presence of pulmonary hypertension a pulmonary artery wedge pressure measurement should not be accepted unless the value is substantially less than the pulmonary artery diastolic pressure. It also affirms the value of documenting arterialisation of aspirated 'wedge' blood in verifying the wedge position.