Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock

Kanwar, Manreet; Blumer, Vanessa; Zhang, Yijing; Sinha, Shashank S.; Garan, A.R.; Hernández-Montfort, Jaime; Khalif, Adnan; Hickey, Gavin; Abraham, Jacob; Mahr, Claudius; Li, Borui; Sangal, Paavni; Walec, Karol; Zazzali, Peter; Kataria, Rachna; Pahuja, Mohit; Ton, Van-Khue; Harwani, Neil; Wencker, Detlef; Nathan, Sandeep; Vorovich, Esther; Hall, Shelley; Khalife, Wissam; Li, Song; Schwartzman, Andrew; Vishnevsky, O. V.; Trinquart, Ludovic; Burkhoff, Daniel; Kapur, Navin K.

doi:10.1016/j.cardfail.2023.05.001

Cited by 20 publications

(10 citation statements)

References 31 publications

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“…168 use of PAC may allow better indication for the escalation and de-escalation strategies and, accordingly, it has recently been associated with improved survival in patients with CS. [159][160][161]168,170 .…”

Section: Escalation and De-escalation: The Importance Of A Multistep ...mentioning

confidence: 99%

“…Lastly, a pulmonary artery pulsatility index <0.9 has been described as the strongest indicator of severe RV failure and may be useful to optimize inotropic support and/or identify patients needing RV MCS 168 . The use of PAC may allow better indication for the escalation and de‐escalation strategies and, accordingly, it has recently been associated with improved survival in patients with CS 159–161,168,170 …”

Section: Inotropic Therapy In Different Clinical Scenariosmentioning

confidence: 99%

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Medical therapy of cardiogenic shock: Contemporary use of inotropes and vasopressors

Riccardi,

Pagnesi,

Chioncel

et al. 2024

European J of Heart Fail

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Cardiogenic shock is a primary cardiac disorder that results in both clinical and biochemical evidence of tissue hypoperfusion and can lead to multi‐organ failure and death depending on its severity. Inadequate cardiac contractility or cardiac power secondary to acute myocardial infarction remains the most frequent cause of cardiogenic shock, although its contribution has declined over the past two decades, compared with other causes. Despite some advances in cardiogenic shock management, this clinical syndrome is still burdened by an extremely high mortality. Its management is based on immediate stabilization of haemodynamic parameters so that further treatment, including mechanical circulatory support and transfer to specialized tertiary care centres, can be accomplished. With these aims, medical therapy, consisting mainly of inotropic drugs and vasopressors, still has a major role. The purpose of this article is to review current evidence on the use of these medications in patients with cardiogenic shock and discuss specific clinical settings with indications to their use.

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Section: Escalation and De-escalation: The Importance Of A Multistep ...mentioning

confidence: 99%

Section: Inotropic Therapy In Different Clinical Scenariosmentioning

confidence: 99%

Medical therapy of cardiogenic shock: Contemporary use of inotropes and vasopressors

Riccardi,

Pagnesi,

Chioncel

et al. 2024

European J of Heart Fail

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“…Observational data suggest that admission to a cardiovascular-specific ICU and the use of a pulmonary artery catheter for guided therapies are associated with improved outcomes and optimal use of resources. [37][38][39] Therefore, transfer to a facility with specialized cardiovascular care capabilities such as a cardiovascularspecific ICU should be an early consideration in the management of CS to optimize patient outcomes and to ensure appropriate monitoring and treatment. In this regard, as part of the early assessment, it is crucial to concomitantly consider the potential need for hospital transfer.…”

Section: Approach To Management Initial Stabilization and Resuscitati...mentioning

confidence: 99%

Cardiogenic Shock in Older Adults: A Focus on Age-Associated Risks and Approach to Management: A Scientific Statement From the American Heart Association

Blumer,

Kanwar,

Barnett

et al. 2024

Circulation

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Cardiogenic shock continues to portend poor outcomes, conferring short-term mortality rates of 30% to 50% despite recent scientific advances. Age is a nonmodifiable risk factor for mortality in patients with cardiogenic shock and is often considered in the decision-making process for eligibility for various therapies. Older adults have been largely excluded from analyses of therapeutic options in patients with cardiogenic shock. As a result, despite the association of advanced age with worse outcomes, focused strategies in the assessment and management of cardiogenic shock in this high-risk and growing population are lacking. Individual programs oftentimes develop upper age limits for various interventional strategies for their patients, including heart transplantation and durable left ventricular assist devices. However, age as a lone parameter should not be used to guide individual patient management decisions in cardiogenic shock. In the assessment of risk in older adults with cardiogenic shock, a comprehensive, interdisciplinary approach is central to developing best practices. In this American Heart Association scientific statement, we aim to summarize our contemporary understanding of the epidemiology, risk assessment, and in-hospital approach to management of cardiogenic shock, with a unique focus on older adults.

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“…Insbesondere beim kardiogenen Schock hat das hämodynamische Management eine große Bedeutung. Retrospektive Analysen weisen darauf hin, dass die vollständige hämodynamische Phänotypisierung die Prognosebeispielsweise mittels Rechtsherzkatheterdieser Patienten verbessern kann [12]. Im Gegensatz zu den Indikationen gibt es bei dem PAK-Monitoring klare Kontraindikationen.…”

Section: Merkeunclassified

Hämodynamisches Management: Katecholamine und andere Vasopressoren/Inotropika

Bruno,

Jung

2023

Intensivmedizin up2date

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Der Beitrag diskutiert die Grundlagen zur hämodynamischen Überwachung und Behandlung bei verschiedenen intensivmedizinischen Erkrankungen, insbesondere beim kardiogenen und septischen Schock. Die genaue hämodynamische Phänotypisierung der Patienten kann bei der medikamentösen Schocktherapie hilfreich sein. Für die Diagnose ist kein invasives hämodynamisches Monitoring zwingend notwendig. Dennoch bleiben das PiCCO- und das Pulmonalarterienkatheter-Verfahren weiterhin Standard in der hämodynamischen Überwachung.

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Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock

Cited by 20 publications

References 31 publications

Medical therapy of cardiogenic shock: Contemporary use of inotropes and vasopressors

Medical therapy of cardiogenic shock: Contemporary use of inotropes and vasopressors

Cardiogenic Shock in Older Adults: A Focus on Age-Associated Risks and Approach to Management: A Scientific Statement From the American Heart Association

Hämodynamisches Management: Katecholamine und andere Vasopressoren/Inotropika

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