The Fast Flush Test Measures the Dynamic Response of the Entire Blood Pressure Monitoring System

The fast flush test (FT) is the only test that allows clinicians to determine in vivo the natural frequency (fn) and damping coefficient (zeta) of an invasive blood pressure monitoring system. The underlying assumption to the validity of the FT is that it activates the whole system including the distal catheter. We devised an in vitro model of a typical invasive blood pressure monitoring system to determine whether this assumption was true. The model consisted of a conventional transducer with a flush device attached to various lengths of connecting tubing (91.4, 182.9, and 274.3 cm) terminated by four different diameter catheters (5.1 cm 14 G, 16 G, 18 G, and 20 G). A microtipped transducer catheter was inserted into the distal catheter tubing system. A FT was performed and the fn and zeta were recorded from the conventional transducer and simultaneously from the microtipped transducer catheter. Similar studies were conducted using the ROSE damping device as well as with systems including 0.1 ml of air near the conventional transducer. These studies utilized 18- and 20-G catheters with each of the three lengths of connecting tubing. All measurements of fn and zeta at the proximal conventional transducer were identical to those measurements as recorded by the distal microtipped transducer catheter. We conclude that the FT activates the whole monitoring system and that fn and zeta are the same throughout the system including the distal catheter.