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Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation

Kalra, Rajat ; Gaisendrees, Christopher ; Alexy, Tamas ; Kosmopoulos, Marinos ; Jaeger, Deborah ; Schlachtenberger, Georg ; Raveendran, Ganesh ; Bartos, Jason A ; Gutierrez Bernal, Alejandra ; John, Ranjit ; Wahlers, Thorsten ; Yannopoulos, Demetris

Frontiers in cardiovascular medicine, 2023-10, Vol.10, p.1271227 [Periódico revisado por pares]

Switzerland: Frontiers Media S.A

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  • Título:
    Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation
  • Autor: Kalra, Rajat ; Gaisendrees, Christopher ; Alexy, Tamas ; Kosmopoulos, Marinos ; Jaeger, Deborah ; Schlachtenberger, Georg ; Raveendran, Ganesh ; Bartos, Jason A ; Gutierrez Bernal, Alejandra ; John, Ranjit ; Wahlers, Thorsten ; Yannopoulos, Demetris
  • Assuntos: Cardiovascular Medicine ; ECLS (VA) ; left ventricular end-diastolic pressure ; LVEDP ; PCWP ; pulmonary capillary wedge pressure ; VA-ECMO
  • É parte de: Frontiers in cardiovascular medicine, 2023-10, Vol.10, p.1271227
  • Notas: These authors have contributed equally to this work
    Reviewed by: Miguel Alvarez Villela, Lenox Hill Hospital, United States Anna Valerianova, General University Hospital in Prague, Czechia Alastair Proudfoot, Barts Heart Centre, United Kingdom
    Edited by: Gary Schwartz, Baylor University Medical Center, United States
  • Descrição: 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 . 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 ( = 0.03,  = 0.66). The PCWP may not correlate well with LVEDP in patients treated with VA-ECMO, particularly at high levels of VA-ECMO support.
  • Editor: Switzerland: Frontiers Media S.A
  • Idioma: Inglês
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