Phlebostatic axis

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phlebostatic axis right atrium leveling reference nursing

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Phlebostatic axis is the external anatomical reference point used to level a pressure transducer when measuring central venous pressure, pulmonary artery pressure, or other invasive cardiac pressures.
  • It approximates the level of the right atrium.
  • In a supine patient, locate the 4th intercostal space at the mid-anteroposterior diameter of the chest.
  • Practically, this is often described as the 4th intercostal space at the midaxillary line.
The transducer is zeroed at this level so that intravascular pressure readings are not falsely high or low because of hydrostatic effects. A transducer positioned below the phlebostatic axis gives a falsely high reading; above it gives a falsely low reading.
Braunwald describes it as the intersection of a transverse plane through the fourth anterior intercostal space and a frontal plane halfway between the posterior body surface and the base of the xiphoid process. - Braunwald’s Heart Disease, Figure 88.9.
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