The contemporary pulmonary artery catheter. Part 2: measurements, limitations, and clinical applications

Bootsma, Inge T.; Boerma, E. Christiaan; Scheeren, Thomas; Lange, Fellery de

doi:10.1007/s10877-021-00673-5

Cited by 48 publications

(40 citation statements)

References 125 publications

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“…Aside from BNP, pulmonary artery catheterization measurements (central venous pressure, pulmonary capillary wedge pressure) [17] and tracer methods (i.e., I131-tagged albumin) can be employed to assess intravascular volume status [18]. However, these procedures are frequently invasive, time-consuming, and costly, and they are not easily available in every healthcare facility.…”

Section: Discussionmentioning

confidence: 99%

Hematocrit change as a predictor of readmission for decompensated heart failure: a retrospective single centre study

Zulastri¹,

Hafidz²,

Ismail³

et al. 2021

Rev. Cardiovasc. Med.

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In patients with acute heart failure (AHF), hemoconcentration has been suggested as a surrogate for volume changes (AHF). However, literatures comparing the outcome of AHF patients that achieved hemoconcentration during hospitalization with those that do not are limited. The aim of this research is to see if achieving hemoconcentration prior to discharge is linked to a lower risk of re-admission in AHF patients. 124 patients hospitalized in the Cardiology Unit, University Malaya Medical Centre (UMMC) for AHF between November 2019 and November 2020 were enrolled. Information on patients' clinical characteristics, laboratory values and in-hospital treatments were collected through electronic medical record. At admission and discharge, the change in hematocrit (HCT) levels was calculated, and patients were stratified based on two quantiles of delta HCT, either discharged with hemoconcentration (∆HCT >1.5%) or without hemoconcentration (∆HCT ≤1.5%). The study's outcome was AHF readmission after a 90-day follow-up period. Readmission was significantly associated with ejection fraction (p = 0.032) and HCT change (p = 0.005). Consecutively, logistic regression performed revealed that patients with haemoconcentration were 78.3% less likely to be readmitted than those without haemoconcentration (OR = 0.217, p = 0.003, 95% CI = 0.078-0.605) and Patients with a lower ejection fraction have a threefold greater chance of being readmitted than those with a preserved ejection fraction (OR = 3.316, p = 0.022, 95% CI = 1.188-9.256). In conclusion, among patients hospitalized and discharged for AHF, those that (i) do not achieve haemoconcentration and (ii) patients with a reduced ejection fraction were more likely to be readmitted with acute heart failure. Therefore, optimising patients' haematocrit levels prior to discharge may potentially reduce rehospitalizations among heart failure patients.

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Section: Discussionmentioning

confidence: 99%

Hematocrit change as a predictor of readmission for decompensated heart failure: a retrospective single centre study

Zulastri¹,

Hafidz²,

Ismail³

et al. 2021

Rev. Cardiovasc. Med.

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“…An extreme case of this is the continuous cardiac output (CCO) measurement from thermodilution pulmonary artery catheters that is only (truly) updated every 4-12 min due to a moving-average algorithm. 26,27 The time window between T2 and T3 is not without concern though. On average, the effect of the MFC is likely to subside during this period, making the patients more fluid responsive at T3 than at T2.…”

Section: A New Reference Measurement After the Mfcmentioning

confidence: 99%

Existing fluid responsiveness studies using the mini‐fluid challenge may be misleading: Methodological considerations and simulations

Enevoldsen

Scheeren

Berg

et al. 2021

Acta Anaesthesiol Scand

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The term mini-fluid challenge (MFC) was coined by Muller et al about a decade ago 1 as a new way to predict fluid responsiveness. At the time, common fluid infusion practice consisted of 'let's give some fluid and see what happens' as highlighted by the accompanying editorial. 2 That 'some fluid' was a fluid challenge of around 500 ml as identified by the FENICE study. 3 Motivated by the finding that fluid

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“…The significant advantage of fast CCOM algorithm allows continuous monitoring of multiple advanced hemodynamic parameters including CO, stroke volume (SV), SvO 2 , systemic vascular resistance (SVR), and RV ejection fraction every 20 s while avoiding volume overload of cold saline injection, as it uses a temperature filament to add heat content to blood flow and measure blood temperature change at PAC tip by a rapid response thermistor [9 ▪▪ ,10 ▪▪ ]. PAC has been the modality of choice in cardiac surgical ICU for differentiating mixed shock [11].…”

Section: Invasive Modalitiesmentioning

confidence: 99%

Cardiac output monitoring – invasive and noninvasive

Arya

Al-Moustadi

Dutta

2022

Current Opinion in Critical Care

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Purpose of reviewThe purpose of this article is to review various contemporary cardiac output (CO) measurement technologies available and their utility in critically ill patients. Recent findingsCO measurement devices can be invasive, minimally invasive, or noninvasive depending upon their method of CO measurement. All devices have pros and cons, with pulmonary artery catheter (PAC) being the gold standard. The invasive techniques are more accurate; however, their invasiveness can cause more complications. The noninvasive devices predict CO via mathematical modeling with several assumptions and are thus prone to errors in clinical situations. Recently, PAC has made a comeback into clinical practice especially in cardiac intensive care units (ICUs). Critical care echocardiography (CCE) is an upcoming tool that not only provides CO but also helps in differential diagnosis. Lack of proper training and nonavailability of equipment are the main hindrances to the wide adoption of CCE. SummaryPAC thermodilution for CO measurement is still gold standard and most suitable in patients with cardiac pathology and with experienced user. CCE offers an alternative to thermodilution and is suitable for all ICUs; however, structural training is required.

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The contemporary pulmonary artery catheter. Part 2: measurements, limitations, and clinical applications

Cited by 48 publications

References 125 publications

Hematocrit change as a predictor of readmission for decompensated heart failure: a retrospective single centre study

Hematocrit change as a predictor of readmission for decompensated heart failure: a retrospective single centre study

Existing fluid responsiveness studies using the mini‐fluid challenge may be misleading: Methodological considerations and simulations

Cardiac output monitoring – invasive and noninvasive

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