Pulmonary Artery Diastolic Pressure as a Surrogate for Pulmonary Capillary Wedge Pressure in Cardiogenic Shock.
J Card Fail
; 30(6): 853-856, 2024 Jun.
Article
in En
| MEDLINE
| ID: mdl-38513886
ABSTRACT
BACKGROUND:
It is common for clinicians to use the pulmonary artery diastolic pressure (PADP) as a surrogate for the pulmonary capillary wedge pressure (PCWP). Here, we determine the validity of this relationship in patients with various phenotypes of cardiogenic shock (CS). METHODS ANDRESULTS:
In this analysis of the Critical Care Cardiology Trials Network registry, we identified 1225 people admitted with CS who received pulmonary artery catheters. Linear regression, Bland-Altman and receiver operator characteristic analyses were performed to determine the strength of the association between PADP and PCWP in patients with left-, right-, biventricular, and other non-myocardia phenotypes of CS (eg, arrhythmia, valvular stenosis, tamponade). There was a moderately strong correlation between PADP and PCWP in the total population (râ¯=â¯0.64, nâ¯=â¯1225) and in each CS phenotype, except for right ventricular CS, for which the correlation was weak (râ¯=â¯0.43, nâ¯=â¯71). Additionally, we found that a PADP ≥ 24 mmHg can be used to infer a PCWP ≥ 18 mmHg with ≥ 90% confidence in all but the right ventricular CS phenotype.CONCLUSIONS:
This analysis validates the practice of using PADP as a surrogate for PCWP in most patients with CS; however, it should generally be avoided in cases of right ventricular-predominant CS.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Pulmonary Artery
/
Shock, Cardiogenic
/
Pulmonary Wedge Pressure
/
Registries
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Year:
2024
Type:
Article