Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation
BackgroundPulmonary 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...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1271227/full |
| _version_ | 1797653008773808128 |
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| author | Rajat Kalra Rajat Kalra Christopher Gaisendrees Christopher Gaisendrees Christopher Gaisendrees Tamas Alexy Tamas Alexy Marinos Kosmopoulos Marinos Kosmopoulos Deborah Jaeger Deborah Jaeger Deborah Jaeger Georg Schlachtenberger Ganesh Raveendran Ganesh Raveendran Jason A. Bartos Jason A. Bartos Alejandra Gutierrez Bernal Alejandra Gutierrez Bernal Ranjit John Thorsten Wahlers Demetris Yannopoulos Demetris Yannopoulos |
| author_facet | Rajat Kalra Rajat Kalra Christopher Gaisendrees Christopher Gaisendrees Christopher Gaisendrees Tamas Alexy Tamas Alexy Marinos Kosmopoulos Marinos Kosmopoulos Deborah Jaeger Deborah Jaeger Deborah Jaeger Georg Schlachtenberger Ganesh Raveendran Ganesh Raveendran Jason A. Bartos Jason A. Bartos Alejandra Gutierrez Bernal Alejandra Gutierrez Bernal Ranjit John Thorsten Wahlers Demetris Yannopoulos Demetris Yannopoulos |
| author_sort | Rajat Kalra |
| collection | DOAJ |
| description | BackgroundPulmonary 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.MethodsPatients 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 R2.ResultsFour 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 (R2 = 0.03, p = 0.66).ConclusionsThe PCWP may not correlate well with LVEDP in patients treated with VA-ECMO, particularly at high levels of VA-ECMO support. |
| first_indexed | 2024-03-11T16:38:12Z |
| format | Article |
| id | doaj.art-843bf94569e24a15834eb8b4c7e8f9f4 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-11T16:38:12Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-843bf94569e24a15834eb8b4c7e8f9f42023-10-23T11:27:15ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-10-011010.3389/fcvm.2023.12712271271227Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenationRajat Kalra0Rajat Kalra1Christopher Gaisendrees2Christopher Gaisendrees3Christopher Gaisendrees4Tamas Alexy5Tamas Alexy6Marinos Kosmopoulos7Marinos Kosmopoulos8Deborah Jaeger9Deborah Jaeger10Deborah Jaeger11Georg Schlachtenberger12Ganesh Raveendran13Ganesh Raveendran14Jason A. Bartos15Jason A. Bartos16Alejandra Gutierrez Bernal17Alejandra Gutierrez Bernal18Ranjit John19Thorsten Wahlers20Demetris Yannopoulos21Demetris Yannopoulos22Cardiovascular Division, University of Minnesota, Minneapolis, MN, United StatesCenter for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, United StatesCardiovascular Division, University of Minnesota, Minneapolis, MN, United StatesCenter for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, United StatesDepartment of Cardiothoracic Surgery, University Hospital of Cologne, Cologne, GermanyCardiovascular Division, University of Minnesota, Minneapolis, MN, United StatesCenter for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, United StatesCardiovascular Division, University of Minnesota, Minneapolis, MN, United StatesCenter for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, United StatesCardiovascular Division, University of Minnesota, Minneapolis, MN, United StatesCenter for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, United StatesINSERMU 1116, University of Lorraine, Vandoeuvre-lès-Nancy, FranceDepartment of Cardiothoracic Surgery, University Hospital of Cologne, Cologne, GermanyCardiovascular Division, University of Minnesota, Minneapolis, MN, United StatesCenter for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, United StatesCardiovascular Division, University of Minnesota, Minneapolis, MN, United StatesCenter for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, United StatesCardiovascular Division, University of Minnesota, Minneapolis, MN, United StatesCenter for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, United StatesCardiothoracic Surgery Division, University of Minnesota, Minneapolis, MN, United StatesDepartment of Cardiothoracic Surgery, University Hospital of Cologne, Cologne, GermanyCardiovascular Division, University of Minnesota, Minneapolis, MN, United StatesCenter for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, United StatesBackgroundPulmonary 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.MethodsPatients 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 R2.ResultsFour 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 (R2 = 0.03, p = 0.66).ConclusionsThe PCWP may not correlate well with LVEDP in patients treated with VA-ECMO, particularly at high levels of VA-ECMO support.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1271227/fullVA-ECMOECLS (VA)PCWPpulmonary capillary wedge pressureLVEDPleft ventricular end-diastolic pressure |
| spellingShingle | Rajat Kalra Rajat Kalra Christopher Gaisendrees Christopher Gaisendrees Christopher Gaisendrees Tamas Alexy Tamas Alexy Marinos Kosmopoulos Marinos Kosmopoulos Deborah Jaeger Deborah Jaeger Deborah Jaeger Georg Schlachtenberger Ganesh Raveendran Ganesh Raveendran Jason A. Bartos Jason A. Bartos Alejandra Gutierrez Bernal Alejandra Gutierrez Bernal Ranjit John Thorsten Wahlers Demetris Yannopoulos Demetris Yannopoulos Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation Frontiers in Cardiovascular Medicine VA-ECMO ECLS (VA) PCWP pulmonary capillary wedge pressure LVEDP left ventricular end-diastolic pressure |
| title | Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation |
| title_full | Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation |
| title_fullStr | Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation |
| title_full_unstemmed | Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation |
| title_short | Case Report: Correlation between pulmonary capillary wedge pressure and left-ventricular diastolic pressure during treatment with veno-arterial extracorporeal membrane oxygenation |
| title_sort | case report correlation between pulmonary capillary wedge pressure and left ventricular diastolic pressure during treatment with veno arterial extracorporeal membrane oxygenation |
| topic | VA-ECMO ECLS (VA) PCWP pulmonary capillary wedge pressure LVEDP left ventricular end-diastolic pressure |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1271227/full |
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