The researchers assessed the prognostic significance of hemodynamic parameters measured during pulmonary artery catheterization. Hemodynamic parameters reflecting decreased systemic arterial tone and right ventricular dysfunction were found to be associated with adverse outcomes and systemic hypoperfusion.
Researchers from Harvard Graduate Medical School in Boston and the universities of New York and San Francisco assessed the prognostic associations and relationships with end-organ dysfunction when obtaining hemodynamic parameters in patients with cardiogenic shock. The study results were published in the European Heart Journal: Acute Cardiovascular Care.
The average cardiac index was 1.9 l/min/m2, and the mean arterial pressure is 74 mm Hg. Parameters associated with an increased risk of death were: low mean arterial pressure, low systolic blood pressure, low systemic vascular resistance, increased right atrial pressure, increased right atrial pressure/pulmonary wedge pressure ratio, and low pulmonary pulsatility index. . Moreover, these parameters were associated with higher serum lactate, which indicates a poor prognosis for the patient.
|Five-year data from 1473 patients admitted to the intensive care unit with cardiogenic shock and available hemodynamic parameters in the first 24 hours after admission were analyzed. The relationship of these parameters with in-hospital mortality rates and serum lactate levels was assessed.
Thus, the authors determined that in a modern population of patients with cardiogenic shock, hemodynamic parameters reflecting a decrease in systemic arterial tone and right ventricular dysfunction are of prognostic value.