Pulmonary Artery Diastolic Pressure as a Surrogate for Pulmonary Capillary Wedge Pressure in Cardiogenic Shock.
Publication/Presentation Date
6-1-2024
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 AND RESULTS: 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 (r = 0.64, n = 1225) and in each CS phenotype, except for right ventricular CS, for which the correlation was weak (r = 0.43, n = 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.
Volume
30
Issue
6
First Page
853
Last Page
856
ISSN
1532-8414
Published In/Presented At
Papolos, A. I., Kenigsberg, B. B., Singam, N. S. V., Berg, D. D., Guo, J., Bohula, E. A., Katz, J. N., Diepen, S. V., Morrow, D. A., & Critical Care Cardiology Trials Network Investigators (2024). Pulmonary Artery Diastolic Pressure as a Surrogate for Pulmonary Capillary Wedge Pressure in Cardiogenic Shock. Journal of cardiac failure, 30(6), 853–856. https://doi.org/10.1016/j.cardfail.2024.02.021
Disciplines
Medicine and Health Sciences
PubMedID
38513886
Department(s)
Department of Medicine
Document Type
Article
