TABLE 3

Potential sources of error when performing right heart catheterisation and guidance on how to minimise the impact of these errors

Potential error class	Potential error	Risk	Solution
Measurement	Catheter balloon over-inflation	False high or low PAWP readings [41]	Half inflation of the balloon (diameter ∼0.9 cm, 0.75 mL air) [42]
	Catheter balloon over-inflation	Pulmonary arterial rupture [41]	Avoid repeated inflations and deflations of the balloon [29]
	Catheter balloon under-inflation	False elevation of PAWP readings [41]	Half inflation of the balloon (diameter ∼0.9 cm, 0.75 mL air) [42]
	Use of end-expiratory PAWP readings	Misdiagnosis of patients with a pre-capillary phenotype [43, 44]	Average PAWP readings across respiratory cycles [44]
	Analysing single cycle	Potential data inaccuracy [44]	Mean values of multiple respiratory cycles should be used [44]
	Variation in the location of the pressure transducer	Nonuniformity of the pressure transducer setting and zero levelling [29, 45]	Standardised location of pressure transducer according to guideline recommendations [1, 2, 40, 44] or adoption of micromanometer-tipped catheters [44]
Data interpretation	Failure to review traces	Data inaccuracy (measurement artefacts) [41]	Each trace should be scrutinised to ensure that it is not affected by artefacts [41]
Technical	Incorrectly maintained or calibrated equipment	Errors in data acquisition [41]	Equipment maintained to a high standard and regular calibration [41]
Technical	Inadequate flushing of the catheter	Dampened waveforms [41]	Adequate flushing [41]