Centimeter Water (4 °C) to Bar

Respiratory medicine adopted cmH₂O because the original ventilators literally used water columns to regulate pressure — a jar of water with a submerged tube set the pressure at whatever depth the tube was immersed. A CPAP setting of 10 cmH₂O meant the air bubbled out at 10 cm depth. The unit stuck even after electronics replaced water seals, because clinicians, patients, and device manuals all speak the same scale.

Most adults are prescribed between 6 and 14 cmH₂O, with 10 cmH₂O being a common starting point. Severe obstructive sleep apnoea may require 15–20 cmH₂O. Auto-titrating (APAP) machines vary pressure within a set range — typically 4–20 cmH₂O — adjusting breath by breath. Higher pressures are more effective at splinting the airway open but can cause discomfort and air swallowing.

ICU ventilators also use cmH₂O. Positive end-expiratory pressure (PEEP) is usually set at 5–15 cmH₂O to keep alveoli open. Peak inspiratory pressure above 30–35 cmH₂O raises the risk of lung injury. Plateau pressures are monitored to stay below 30 cmH₂O. The entire field of mechanical ventilation runs on this single unit because it directly corresponds to the pressures inside the lung.

Measured via lumbar puncture with the patient lying on their side, normal CSF pressure is 10–18 cmH₂O in adults. Above 25 cmH₂O suggests raised intracranial pressure — potentially from a tumor, meningitis, or hydrocephalus. Below 6 cmH₂O indicates low pressure, often from a CSF leak. Neurologists use cmH₂O rather than mmHg because spinal fluid is essentially water, making the unit a direct physical analogue.

1 cmH₂O ≈ 0.981 mbar ≈ 0.0981 kPa. For bedside estimates, 1 cmH₂O ≈ 1 mbar is close enough (error under 2%). A CPAP setting of 12 cmH₂O is about 11.8 mbar or 1.18 kPa. Since respiratory equipment universally reads cmH₂O, conversion is mainly needed when interfacing with industrial instruments or when charting pressures alongside blood gas data reported in mmHg.

Europe adopted metric units broadly in the 19th and 20th centuries, and the bar (100,000 Pa) became the natural metric pressure unit for everyday engineering. The US never metricated, so pounds per square inch persisted. A car tire at 2.2 bar is the same as 32 psi — most modern tire placards list both. If you rent a car abroad and the pump reads bar, just divide your usual psi number by 14.5.

Standard aluminum scuba cylinders are rated to 200 bar (2,900 psi); steel tanks often go to 232 or 300 bar. At 200 bar, the air inside is compressed to 1/200th of its surface volume — a 12-liter tank holds 2,400 liters of breathing gas. Deep technical divers using trimix may use 300-bar steel tanks to maximize bottom time at extreme depths.

Close, but not quite. One bar is exactly 100,000 Pa; one standard atmosphere is 101,325 Pa — about 1.3% higher. The bar was designed as a round-number metric unit, not an exact atmospheric equivalent. For most practical purposes (cooking, tire inflation, diving rules of thumb) the difference is negligible, but in chemistry and calibration work the distinction matters.

Espresso machines run at 9 bar, car tires at 2–2.5 bar, a fire extinguisher at 12–15 bar, a garden pressure washer at 100–150 bar, and a diesel fuel injection rail at up to 2,500 bar. The range from gentle (carbonated water at 2–4 bar) to extreme (waterjet cutting at 4,000+ bar) makes the bar a versatile everyday engineering unit.

The SI only recognizes base and coherently derived units — pressure in SI is strictly the pascal (kg·m⁻¹·s⁻²). The bar is accepted "for use with SI" but is technically an outside unit, like the liter or the hour. The reason it thrives anyway is convenience: 2.2 bar is far friendlier than 220,000 Pa for a tire label, and industry adoption is too deep to reverse.