Pulmonary capillary pressure and pulmonary capillary wedge pressure (PCWP) | Dr Vivek Nalgirkar |

[@georgeiribar8412]

Sr. You speak very clear and direct, your concepts are crystal clear. Good job.

[@VivekSirsPhysiology]

Thanks…!

[@JJ-ey5zj]

thank you i have been struggling ti understand this concept for so long. now i understand. thank you

[@talnir5483]

best video ever about this subject. thank you so much

[@VivekSirsPhysiology]

Thanks

[@alexsheremett3097]

there was a question raised : what account for the difference between pulmonary pressure and wedge pressure...

[@VivekSirsPhysiology]

Mentioned it in the video. Pulmonary pressure is when blood is freely flowing through the pulmonary circuit. Wedge pressure when the flow is obstructed.

[@alexsheremett3097]

@@VivekSirsPhysiology Ok.. But my question is WHY the pressure when the flow is blocked is lower than in pulmonary artery ... However to my senses it should be at least higher... Logically speaking l

[@VivekSirsPhysiology]

@@alexsheremett3097 Well it means, the concept needs to be revisited. We are not looking for the pressure BEFORE the wedge. We are looking for the pressure BEYOND the wedge. Coz, that’s where lies the left atrium. And this whole exercise is to measure the pressure in the LA.

[@idaraakpan1417]

I love this!!! this has answered so many questions that I had.

[@faizankhan-jp2my]

That is why pcwp is more in Left ventricular heart failure then right vent heart failure.. Thanku for this amazing concept

[@SardarKhan-mf5lu]

Thank you sir finally understood this after 5 years

[@Dr.M.Ahmed-641]

I've taken 2 of your lectures and now I'm your fan sir, great way of explanation. Thanks. Love from Pakistan ❤️.

[@VivekSirsPhysiology]

@@Dr.M.Ahmed-641 Really…?! Wow. Great to hear this. Keep asking doubts. Make the subject strong. Regards,

[@doctorelectron5998]

Hats 🎩 off sir ☺️ you r the only one who made me understand it

[@VivekSirsPhysiology]

Thanks..!

[@Anelej96]

amazingly explained!! thank you legend! 💪

[@joseemiliano5947]

Huge thanks for the clear explanation, Sir! really helped me on my studies.

[@VivekSirsPhysiology]

Welcome..!

[@jerzlemolina1419]

Thank you sir! I have difficulty understanding it but you made it easier for me to comprehend.

[@VivekSirsPhysiology]

@@jerzlemolina1419 welcome.

[@harimurugan2324]

Best explanantion

[@surbhisharma7594]

The explanation is so simple and very good

[@VivekSirsPhysiology]

@@surbhisharma7594 Thanks.

[@dineshchandra4846]

Thank you sir….understood very well and easy

[@shahabuddin6149]

What a great lecture,more beneficial for me thanks sir keep it up

[@VivekSirsPhysiology]

Keep watching

[@mgims02]

very nice sir, i watched during my mrcs prepartion , good clarity . please make more

[@VivekSirsPhysiology]

Oh sure. Thx.

[@pinkdiesel]

thank you sir 😊

[@salmawaleed3390]

Perfectly explained 👏🏻

[@VivekSirsPhysiology]

Thanks

[@halahammoda9248]

Nice work Thanks 🌸🌸🌸

[@VivekSirsPhysiology]

@@halahammoda9248 Thanks

[@kishusain6607]

Thanku so much to give such a clear explanation......

[@sayedasubiya-gu6zu]

Fabulous explanation

[@VivekSirsPhysiology]

Thanks..!

[@madihaanwar7991]

Thanks Sir, u explained very nicely.

[@VivekSirsPhysiology]

Thanks!

[@yahyaaljuba4238]

Nice explanation sir

[@VivekSirsPhysiology]

Thanks…!

[@vibrantm9298]

thank you for the video , clearly explained

[@VivekSirsPhysiology]

Glad it was helpful!

[@ines4802]

thank you professor ! I have a question though (which may be a little ignorant), when measuring PCWP, why is the pressure in left atrium not inferior since its a chamber of a bigger volume compared to the pulmonary capillaries ? (there is more free space, so wouldn't it be more low pressure ?)

[@VivekSirsPhysiology]

Hello. Yes, that’s the case normally. And hence the blood flows from the pulmonary capillaries to the left atrium (high to low pressure). In measuring of PCWP though, we are creating a wedge and stopping the blood flow. From the point of the wedge up to left atrium, there is no flow for some time. Since no flow, there is no drop of pressure. From the point of wedge to LA, it becomes an equilibrated system or chamber (for a while), with entire distance having the SAME pressure. So, if we measure the pressure just beyond the wedge, it gives us the LA pressure.

[@ines4802]

@@VivekSirsPhysiology thank you !

[@axoltaxis5313]

thank you sir !

[@RashmilaGamage]

Superb explanation sir. I have a question. If we were asked about the equal spO2 to pulmonary capillary wedge position, is it still only the Left atrium or are there any other structures with similar spO2 to pulmonary capillary wedge position.

[@VivekSirsPhysiology]

I think, SPO2 in the pulmonary capillary wedge position is when oxygenation of blood has happened. So, the SPO2 will be similar to left side of the heart and the systemic arteries.

[@RashmilaGamage]

@@VivekSirsPhysiology Thank you very much for the very quick response sir. And another thing , sir should we consider about the physiological shunting here.

[@VivekSirsPhysiology]

@@RashmilaGamage yes we should. That’s why i said ‘similar’, not exactly the same. With shunted blood, left side of heart and systemic blood will have slightly lower PO2 .

[@RashmilaGamage]

@@VivekSirsPhysiologyThank you very much sir! ☺️

[@mikuprepladder]

sir can you please explain again pul cap wedge pressue if there is no flow then how there is no pressure drop/ change / difference because if there is no flow then there would be fall in presure and sir can you please explain what is pulmonary end diastolic pressure

[@VivekSirsPhysiology]

Flow, whenever it occurs, is due to the pressure difference. Now imagine that we have created a wedge. The blood flow reaching the wedge can not cross the wedge. All its kinetic energy is dissipated. So whatever pressure was there in the pulmonary vessels, it will be before the wedge. Beyond, there is a continuous path without any flow. So, left atrial pressure will be the pressure in that entire path, beyond the wedge.

[@VivekSirsPhysiology]

Pulmonary end diastolic pressure is 8 mm Hg.

[@mikuprepladder]

thank you very much sir now i got the concept only i wasnt able to understand the continous path?@@VivekSirsPhysiology

[@VivekSirsPhysiology]

Can you please DM ? It will be easy to reply , and there will be notification too.

[@sohailislam39]

Excellent sir

[@VivekSirsPhysiology]

Thanks…!

[@KholoudMohamed-h4l]

❤ awesome

[@ayushdas_01]

Thanks sir

[@VivekSirsPhysiology]

Welcome

[@suhasdhole5170]

Sir... pulmonary artery catheter is inserted through IJV ..not through any other vein..in clinical practice

[@VivekSirsPhysiology]

Thanks……I stand corrected. Regards,

[@PreeteshKumar-w9u]

Thank you Sir I have two questions 1) Is PCWP also a measure of LVEDP ? 2) Why PCWP falls in ARDS ?

[@VivekSirsPhysiology]

PCWP primarily measures the LA pressure. However, a rise in LVEDP will also increase the LA pressure (due to congestion), and consequently will show up in PCWP. ARDS will compress the pulmonary vessels. Blood flow to LA will decrease. LA pressure will decrease, hence, PCWP will decrease (remember, it’s NOT the pulmonary capillary pressure; it’s the LA pressure.)

[@ishasharma6079]

Could you make a video explaining hysteresis and how surface tension/surfactant concentration in the alvioli may influence it?

[@VivekSirsPhysiology]

kzbin.info/www/bejne/e6vNqWZnZtFnrKM

[@VivekSirsPhysiology]

Two videos are already there. Compliance part 1 and part 2. Hysteresis and effect of surface tension explained. Check it out; playlist of Respiratory system

[@ishasharma6079]

@@VivekSirsPhysiology thanks!! Will watch them right now but I have a quick question. I was wondering, if you have lungs in which surfactant has been removed, will the hysteresis in their Pressure Volume curve increase or decrease from normal conditions? I will really appreciate an answer. Thanks!

[@VivekSirsPhysiology]

@@ishasharma6079 if surfactant is removed, in all probability, water might get filled into alveoli. Surfactant is partly responsible for keeping the alveoli dry. Now, if alveoli are filled with water, the hysteresis will decrease. The pressure-volume relation will become quite linear, and will follow similar path in inspiration and expiration.

[@ishasharma6079]

@@VivekSirsPhysiology so like saline filled lungs? And what would be the effect on compliance would u say? Thanks!

[@ehadalbusaidi4779]

Wow such a genius ❤

[@huzaifashareef471]

Big fan sir!

[@VivekSirsPhysiology]

Thanks…!

[@Khan.Ahamad450]

Best best best

[@FunkyWeb14]

Good day I have a question please if anyone can answer ,it will be great :) So By inserting the catheter through the pulmonary valve, it won't damage it or not letting it close properly ? After the procedure can't it cause some kind of regurgitation etc ? same goes for the tricuspid . Thank you

[@VivekSirsPhysiology]

Cardiac catheterization is an established procedure. It is done under radiographic guiding. There are catheters with special tips. It is not a damaging procedure.

[@FunkyWeb14]

@@VivekSirsPhysiology Thank you sir, Have a wonderful day . And God bless you for all the help you're giving to your fellow students

[@saraali-ho8fx]

❤❤❤

[@TechnoNeelpariHIMACHAL]

Good evening Sir Could you please suggest topic for thesis

[@VivekSirsPhysiology]

Current trends (in Physiology) are - Lifestyle intervention, sports medicine, yoga, aviation physiology. It depends on availability of resources. For example, if a gym is available nearby, or some sports academy, then the topic can be - “Effects of various nutritional supplements on the muscle mass and endurance”. If yoga center is available, then - “effects on pranayam breathing or nostril breathing on neurophysiological parameters”. If hospital is available nearby then - “effects of lifestyle intervention on various lifestyle diseases (like dose reduction, subjective improvement, etc)”

[@TechnoNeelpariHIMACHAL]

Thank you so much Sir 😊🙏

[@applewhite6544]

🙏🙏🙏🙏

[@TechnoNeelpariHIMACHAL]

I mean best book from where we can write paper for Pg exam Sir suggest any topic for thesis

[@VivekSirsPhysiology]

Ganong, and Berne & Levy are the two best titles. Understand the concepts from Berne & Levy, then, write answers from Ganong.

[@TechnoNeelpariHIMACHAL]

Thank you so much Sir 😊

[@TechnoNeelpariHIMACHAL]

Good afternoon Sir Plz suggest best book for MD physiology Pg exam

[@VivekSirsPhysiology]

I think I missed this msg. Is it still relevant? If it is, then the two books that are close to my heart are - Berne & Levy, and Boron and Boulpaep. Then of course there is Ganong.

[@BlastBeeeats]

👍🏽

[@chkdesahiba7487]

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[@tomcruise9317]

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