Cardiology Letters 2024, 33(5):327-337
Invasive hemodynamic monitoring
- I. Kardiologická klinika UPJŠ LF a VÚSCH, a. s., Košice, Slovenská republika
Invasive hemodynamic monitoring is crucial in critically ill patients and its goal is to identify the cause of the present condition, clarification of its etiology and, based on the results obtained, tailoring an optimal therapy. The number of patients with cardiogenic shock has doubled in the last decade with heart failure etiology dominant, surpassing acute coronary syndromes. This review article focuses on two methods - right heart catheterization and transpulmonary thermodilution - and their utilization mainly in patients with acute heart failure. Right heart catheterization is being performed in the whole spectrum of heart failure patients, from those who are hemodynamically stable up to those critically ill in cardiogenic shock with the need of continuous hemodynamic monitoring, as well as in patients in whom advanced heart failure therapies such left ventricular assist device or heart transplantation is being considered. Transpulmonary thermodilution is mainly being used in patients with shock states and acute respiratory distress syndrome in the absence of right ventricular dysfunction. In the hands of skilled doctors they can provide valuable information and aid in guiding treatment, and based on the latest observational trials, might decrease mortality.
Keywords: right heart catheterization; heart failure; transpulmonary thermodilution
Published: May 1, 2024 Show citation
References
- Vincent JL. Indications for haemodynamic monitoring. In: Masip J, editor. Handbook of Acute CardioVascular Monitoring. European Society of Cardiology; 2022:15-21.
- Pinsky MR, Hravnak M. Overview of haemodynamic monitoring. In: Masip J, editor. Handbook of Acute CardioVascular Monitoring. European Society of Cardiology; 2022:7-14.
- Hamzaoui O, Boissier F. Hemodynamic monitoring in cardiogenic shock. J Intensive Med. 2022;3:104-113.
Go to original source... - Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer Ch, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med 2014;40:1795-1815.
Go to original source... - Levy B, Bastien O, Karim B, Cariou A, Chouihed T, Combes A, et al. Experts' recommendations for the management of adult patients with cardiogenic shock. Ann Intensive Care 2015;5:52.
Go to original source... - Chioncel O, Parissis J, Mebazaa A, Thiele H, Desch S, Bauersachs J, et al. Epidemiology, pathophysiology and contemporary management of cardiogenic shock - A position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2020;22:1315-1341.
Go to original source... - Zeymer U, Bueno H, Granger CB, Hochman J, Huber K, Lettino M, et al. Acute Cardiovascular Care Association position statement for the diagnosis and treatment of patients with acute myocardial infarction complicated by cardiogenic shock: a document by the Acute Cardiovascular Care Association of the European Society of Cardiology. Eur Heart J Acute Cardiovasc Care 2020;9:183-197.
Go to original source... - Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2022;79:e263-e421.
- Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;62:e147-239.
Go to original source... - McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bőhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021;42:3599-3726.
Go to original source... - Van Diepen S, Katz JN, Albert NM, Henry TD, Jacobs AK, Kapur NK, et al. Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association. Circulation 2017;136:e232-e268.
Go to original source... - Jentzer JC, Ahmed AM, Vallabhajosyula S, Burstein B, Tabi M, Barsness GW, et al. Shock in the cardiac intensive care unit: Changes in epidemiology and prognosis over time. Am Heart J 2021;232:94-104.
Go to original source... - Naidu SS, Baran DA, Jentzer JC, Hollenberg SM, Van Diepen S, Basir MB, et al. SCAI SHOCK Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies: This statement was endorsed by the American College of Cardiology (ACC), American College of Emergency Physicians (ACEP), American Heart Association (AHA), European Society of Cardiology (ESC), Association of Acute Cardiovascular Care (ACVC), International Society for Heart and Lung Transplantation (ISHLT), Society of Critical Care Medicine (SCC), and Society of Thoracic Surgeons (STS) in December 2021. J Am Coll Cardiol 2022;79:993-946.
Go to original source... - Jentzer JC, van Diepen S, Barsness GW, Henry TD, Menon V, Rihal CS, et al. Cardiogenic Shock Classification to Predict Mortality in the Cardiac Intensive Care Unit. J Am Coll Cardiol 2019;74:2117-2128.
Go to original source... - Jentzer JC, Lawler PR, Van Diepen S, Henry TD, Menon V, Baran DA, et al. Systemic inflammatory response syndrome is associated with increased mortality across the spectrum of shock severity in cardiac intensive care patients. Circ Cardiovasc Qual Outcomes 2020;13:e006956.
Go to original source... - Padkins M, Breen T, Anavekar N, Van Diepen S, Hendry TD, Baran DA, et al. Age and shock severity predict mortality in cardiac intensive care unit patients with and without heart failure. ESC Heart Fail 2020;7:3971-3982.
Go to original source... - Thayer KL, Zweck E, Ayouty M, Garan AR, Hernandez-Montfort J, Mahr C, et al. Invasive hemodynamic assessment and classification of in-hospital mortality risk among patients with cardiogenic shock. Circ Heart Fail 2002;13:e007099.
Go to original source... - Zweck E, Thayer KL, Helgestad OKL, Kanwar M, Ayouty M, Garan AR, et al. Phenotyping Cardiogenic Shock. J Am Heart Assoc 2021;10:e020085.
Go to original source... - Combes A, Berneau JB, Luyt CE, Trouillet JL. Estimation of left ventricular systolic function by single transpulmonary thermodilution. Intensive Care Med 2004;30:1377-1383.
Go to original source... - Monnet X, Teboul JL. Transpulmonary thermodilution: advantages and limits. Crit Care 2017;21:147.
Go to original source... - Biais M, Nouette-Gaulain K, Cottenceau V, Vallet A, Cochard JF, Revel P, et al. Cardiac output measurement in patients undergoing liver transplantation: pulmonary artery catheter versus uncalibrated arterial pressure waveform analysis. Anesth Analg 2008;106:1480-1486.
Go to original source... - Monnet X, Anguel N, Naudin B, Jabot J, Richard C, Teboul JL. Arterial pressure-based cardiac output in septic patients: different accuracy of pulse contour and uncalibrated pressure waveform devices. Crit Care 2010;14:R109.
Go to original source... - Pérez PJ, Darias-Delbey B. Essential invasive and less-invasive calibrated techniques (PAC or two catheters). In: Masip J, editor. Handbook of Acute CardioVascular Monitoring. European Society of Cardiology; 2022:32-40.
- Belda FJ, Aguilar G, Teboul JL, Pestaña D, Malbrain M, Luis JC, et al. Complications related to less-invasive haemodynamic monitoring. Br J Anaesth 2011;106:482-486.
Go to original source... - Conrad AM, Loosen G, Boesing C, Thiel M, Luecke T, Rocco PRM, et al. Effects of changes in veno-venous extracorporeal membrane oxygenation blood flow on the measurement of intrathoracic blood volume and extravascular lung water index: a prospective interventional study. J Clin Monit Comput 2023;37:599-607.
Go to original source... - Gavelli F, Shi R, Teboul JL, Azzolina D, Mercado P, Jozwiak M, et al. Extravascular lung water levels are associated with mortality: a systematic review and meta-analysis. Crit Care 2022;26:202.
Go to original source... - Kor DJ, Warner DO, Carter RE, Meade LA, Wilson GA, Li M, et al. Extravascular lung water and pulmonary vascular permeability index as markers predictive of postoperative acute respiratory distress syndrome: a prospective cohort investigation. Crit Care Med 2015:43:665-673.
Go to original source... - Wang B, Cai L, Lin B, He Q, Ding X. Effect of pulse indicator continuous cardiac output monitoring on septic shock patients: a meta-analysis. Comput Math Methods Med 2022;2022:8604322.
Go to original source... - Rajagopalan N, Borlaug BA, Bailey AL, Eckman PM, Guglin M, Hall S et al. Practical Guidance for Hemodynamic Assessment by Right Heart Catheterization in Management of Heart Failure. JACC Heart Fail 2024;12:1141-1156.
Go to original source... - Rodenas-Alesina E, Brahmbhatt DH, Mak S, Ross HJ, Luk A, Rao V, et al. Value of Invasive Hemodynamic Assessments in Patients Supported by Continuous-Flow Left Ventricular Assist Devices. JACC Heart Fail 2024;12:16-27.
Go to original source... - Rudiger A, Stuby J. Intravascular access. In: Masip J, editor. Handbook of Acute CardioVascular Monitoring. European Society of Cardiology; 2022:23-31.
- Kalvodová Z. Right heart catheterization - methodology, indications, focus on patients in cardiogenic shock. Cardiology Lett 2022;31:236-248.
- Grafton G, Cascino TM, Perry D, Ashur C, Koelling TM. Resting oxygen consumption and heart failure: importance of measurement for determination of cardiac output with the use of the Fick principle. J Card Fail. 2020;26:664-672.
Go to original source... - Jansen JR. The thermodilution method for the clinical assessment of cardiac output. Intensive care med 1995;21:691-697.
Go to original source... - Viray MC, Bonno EL, Gabielle ND, Maron BA, Atkins J, Amoroso NS, et al. Role of pulmonary artery wedge pressure saturation during right heart catheterization: a prospective study. Circ Heart Fail 2020;13:e007981.
Go to original source... - Reddy YNV, ElSabbagh A, Nishimura RA. Comparing pulmonary arterial wedge pressure and left ventricular end diastolic pressure for assessment of left-sided filling pressures. JAMA Cardiol 2018;3:453-454.
Go to original source... - Morine KJ, Kiernan MS, Pham DT, Paruchuri V, Denofrio D, Kapur NK. Pulmonary artery pulsatility index is associated with right ventricular failure after left ventricular assist device surgery. J Card Fail 2016;22:110-116.
Go to original source... - Jain P, Thayer KL, Abraham J, Everett KD, Pahuja M, Whitehead EH, et al. Right ventricular dysfunction is common and identifies patients at risk of dying in cardiogenic shock. J Card Fail 2021;27:1061-1072.
Go to original source... - Fincke R, Hochman JS, Lowe AM, Menon V, Slater JN, Webb JG, et al. Cardiac power is the strongest hemodynamic correlate of mortality in cardiogenic shock: a report from the SHOCK trial registry. J Am Coll Cardiol 2004;44:340-348.
Go to original source... - Baldetti L, Pagnesi M, Gallone G, Barone G, Fierro N, Calvo F, et al. Prognostic value of right atrial pressure-corrected cardiac power index in cardiogenic shock. ESC Heart Fail 2022;9:3920-3930.
Go to original source... - Binanay C, Califf RM, Hasselblad V, O'Connor CM, Shah MR, Sopko G, et al. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA 2005;294:1625-1633.
Go to original source... - Shah MR, Hasselblad V, Stevenson LW, Binanay C, O'Connor CM, Sopko G, et al. Impact of the pulmonary artery catheter in critically ill patients: meta-analysis of randomized clinical trials. JAMA 2005;294:1664-1670.
Go to original source... - Hernandez GA, Lemor A, Blumer V, Rueda CA, Zalawadiya S, Stevenson LW, et al. Trends in Utilization and Outcomes of Pulmonary Artery Catheterization in Heart Failure With and Without Cardiogenic Shock. J Card Fail 2019:25:364-371.
Go to original source... - Garan AR, Kanwar M, Thayer KL, Whitehead E, Zweck E, Hernandez-Montfort J, et al. Complete Hemodynamic Profiling With Pulmonary Artery Catheters in Cardiogenic Shock Is Associated With Lower In-Hospital Mortality. JACC Heart Fail 2020;8:903-913.
Go to original source... - Kadosh BS, Berg DD, Bohula EA, Park JG, Baird-Zars VM, Alviar C, et al. Pulmonary Artery Catheter Use and Mortality in the Cardiac Intensive Care Unit. JACC Heart Fail 2023;11:903-914.
Go to original source... - Bertaina M, Galluzzo A, Rossello X, Sbarra P, Petitti E, Prever SB, et al. Prognostic implications of pulmonary artery catheter monitoring in patients with cardiogenic shock: A systematic review and meta-analysis of observational studies. J Crit Care 2022;69:154024.
Go to original source... - Papolos AI, Kenigsberg BB, Berg DD, Alviar CL, Bohula E, Burke JA, et al. Management and Outcomes of Cardiogenic Shock in Cardiac ICUs With Versus Without Shock Teams. J Am Coll Cardiol 2021;28:1309-1317.
Go to original source... - Kanwar MK, Blumer V, Zhang Y, Sinha SS, Garan AR, HernandezMontfort J, et al. Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock. J Card Fail 2023;29:1234-1244.
Go to original source...

