Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation.
Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation.
复制标题
DOI：
10.3389/fcvm.2023.1271227
复制
发表时间：
2023
影响因子：
3.6
通讯作者：
Yannopoulos, Demetris
中科院分区：
文献类型：
--
作者：
Kalra, Rajat;Gaisendrees, Christopher;Alexy, Tamas;Kosmopoulos, Marinos;Jaeger, Deborah;Schlachtenberger, Georg;Raveendran, Ganesh;Bartos, Jason A.;Bernal, Alejandra Gutierrez;John, Ranjit;Wahlers, Thorsten;Yannopoulos, Demetris
关键词：
肺动脉毛细血管楔压（PCWP）常被用作心源性休克和心脏骤停患者（LVEDP）接受静脉-动脉体外膜氧合（V-A ECMO）支持时左室舒张末期压的替代指标。然而，在使用V-A ECMO的情况下，PCWP与LVEDP的相关性尚不清楚。我们试图在本病例系列中评估这种相关性。患者被转介到我们的心导管实验室进行有创血流动力学研究，以评估他们是否准备好进行VA-ECMO脱管。所有患者同时行左、右心导管置入。使用标准技术，我们同时测量了PCWP和LVEDP。连续变量以四分位数范围的中位数报告。采用简单线性回归评估PCWP与LVEDP之间的相关性，并报告R2。4例患者在VA-ECMO插管后4（2.5,7）天进行了有创血流动力学研究。所有4例患者均发生了院内心脏骤停，并进行了VA-ECMO。在基线VA-ECMO流量为4.1 (3.8,4.4)L/min时，中位LVEDP和PCWP分别为6 (4,7.5)mmHg和12 (6.5,16)mmHg。在VA-ECMO最低流量1.9 (1.6,2.0)L/min时，中位LVEDP和PCWP分别为13.5 (8.5,16)mmHg和15 (13,18)mmHg。同时测定的PCWP与LVEDP相关性较差（R2 = 0.03, p = 0.66）。在接受VA-ECMO治疗的患者中，PCWP可能与LVEDP没有很好的相关性，特别是在高水平的VA-ECMO支持下。
Pulmonary capillary wedge pressure (PCWP) is often used as a surrogate for left-ventricular end-diastolic pressure in patients (LVEDP) who are on veno-arterial extracorporeal membrane oxygenation (V-A ECMO) support for cardiogenic shock and cardiac arrest. However, the correlation between PCWP and LVEDP is not clear in the setting of V-A ECMO usage. We sought to evaluate this correlation in this case series. Patients were referred to our cardiac catheterization laboratory for invasive hemodynamic studies to assess their readiness for VA-ECMO decannulation. All patients underwent simultaneous left and right heart catheterization. Using standard techniques, we measured PCWP and LVEDP simultaneously. Continuous variables were reported as medians with interquartile ranges. The correlation between PCWP and LVEDP was evaluated using simple linear regression and reported as R2. Four patients underwent invasive hemodynamic studies 4 (2.5, 7) days after VA-ECMO cannulation. All four patients had suffered in-hospital cardiac arrest and had been put on VA-ECMO. At the baseline level of VA-ECMO flow of 4.1 (3.8, 4.4) L/min, the median LVEDP and PCWP were 6 (4, 7.5) mmHg and 12 (6.5, 16) mmHg, respectively. At the lowest level of VA-ECMO flow of 1.9 (1.6, 2.0) L/min, the median LVEDP and PCWP was 13.5 (8.5, 16) mmHg and 15 (13, 18) mmHg, respectively. There was a poor correlation between the simultaneously measured PCWP and LVEDP (R2 = 0.03, p = 0.66). The PCWP may not correlate well with LVEDP in patients treated with VA-ECMO, particularly at high levels of VA-ECMO support.
登录
查看更多内容
影响因子：
37.8
作者：
Saxena, Abhinav;Garan, A. Reshad;Kern, Morton
通讯作者：
Kern, Morton
影响因子：
24
作者：
Burkhoff, Daniel;Sayer, Gabriel;Uriel, Nir
通讯作者：
Uriel, Nir
影响因子：
120.7
作者：
Belohlavek, Jan;Smalcova, Jana;Linhart, Ales
通讯作者：
Linhart, Ales
影响因子：
4.8
作者：
Yannopoulos, Demetris;Kalra, Rajat;Aufderheide, Tom P.
通讯作者：
Aufderheide, Tom P.
影响因子：
5.4
作者：
Yannopoulos, Demetris;Bartos, Jason A.;Aufderheide, Tom P.
通讯作者：
Aufderheide, Tom P.