Aedating v4 1

See: contributions: Tan CO conceived and designed the study, was involved in data collection, analysed and interpreted data, drafted and revised the manuscript, gave approval for the final manuscript, and agrees to be accountable for all aspects, accuracy and integrity of the work involved; Weinberg L and Story DA assisted in conceptualisation and design of the study, was involved in data collection, analysed and interpreted data, revised the manuscript, gave approval for the final manuscript, and agrees to be accountable for all aspects, accuracy and integrity of the work involved; Mc Nicol L assisted in design of the study, revised the manuscript, gave approval for the final manuscript, and agrees to be accountable for all aspects, accuracy and integrity of the work involved.

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A sonographer blinded to all pressure waveform information confirmed visualisation of an “empty” PA before PAC insertion, and visualisation of the PAC balloon in the main PA (MPA) or right PA (RPA) after attempts at placement were complete.RESULTS: Appropriate positioning of the PAC balloon, and its to-and-fro movement consistent with a non-wedged state, within the MPA or RPA was confirmed by TTE in 98 of the 103 patients [sensitivity 95% (95%CI: 89%-98%)], and absence of the PAC balloon before insertion correctly established in 100 patients [specificity 97% (92%-99%)].This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers.It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

Agreement, sensitivity and specificity of TTE in confirming appropriate PAC placement was compared against pressure waveform guidance as the “gold standard”.

The successful view used was compared against patients’ anthropomorphic indices, presence of lung hyperinflation, and insertion of PAC during positive pressure ventilation.

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