Centimeter Water (4 °C) to Pound per Square Foot

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.

Because building loads — snow, wind, furniture, people — are naturally distributed over large floor and wall areas measured in square feet. A residential floor designed for 40 psf live load makes intuitive sense: imagine 40 pounds sitting on each square foot of carpet. Converting to psi (0.278 psi) gives a fraction that obscures the physical picture. The US International Building Code specifies all loads in psf for this reason.

Residential living areas: 40 psf. Office floors: 50 psf. Retail stores: 75–100 psf. Library stack rooms: 150 psf. Heavy manufacturing: 250+ psf. Balconies and decks: 60 psf minimum. Roofs must handle snow load (varies by region — 20 psf in Atlanta, 50+ psf in Minnesota) plus a minimum 20 psf construction live load. These values have decades of structural failure data baked into them.

1 psf = 1/144 psi ≈ 0.00694 psi = 47.88 Pa. To go from psi to psf, multiply by 144 (since 1 ft² = 144 in²). Standard atmospheric pressure is about 2,116 psf — which demonstrates why the unit is sized for building loads, not gas pressures. For international projects, multiply psf by 47.88 to get pascals, or by roughly 4.88 to get kgf/m².

Wind pressure scales with the square of wind speed. At 70 mph: about 12 psf. At 100 mph: ~25 psf. At 150 mph (Category 4 hurricane): ~56 psf. Building codes apply additional factors for height, exposure, and shape — a tall building in open terrain sees higher effective psf than a squat building sheltered by trees. Cladding and windows are tested against these design pressures before installation.

Rarely. Most countries use kilopascals (kPa) or kilonewtons per square meter (kN/m²) for structural loads — both are SI-compatible and numerically equivalent (1 kPa = 1 kN/m²). The psf is essentially a US-only unit, found in IBC (International Building Code, despite the name) and ASCE 7 load standards. Engineers working on international projects routinely convert psf to kPa by multiplying by 0.04788.