Background : In many animal experiments, it is vital to detect sudden changes in cardiac output(CO). This porcine study compared CO that was measured with a SwanGanz pulmonary catheter with the gold standard(which was...Background : In many animal experiments, it is vital to detect sudden changes in cardiac output(CO). This porcine study compared CO that was measured with a SwanGanz pulmonary catheter with the gold standard(which was a transit-time flow probe around the pulmonary artery) during interventions that caused hemodynamic instability.Methods : In one series, 7 pigs were exposed to sudden changes in CO. In another series, 9 pigs experienced more prolonged changes in CO. All the pigs had a Swan-Ganz catheter placed into the pulmonary artery and a flow probe around the pulmonary artery. Adrenaline infusion and controlled hemorrhage were used to increase and decrease CO, respectively. The measurements of CO before and after each intervention were compared for correlation, agreement, and the time delay that it took each method to detect at least a 30% change in CO. A Bland– Altman test was used to identify correlations and agreements between the methods.Results : In the first series, there was a delay of 5– 7 min for the Swan Ganz catheter to register a 30% change in cardiac output, compared with the flow probe. However,during prolonged changes in CO in the second series, there was a good correlation between the 2 methods. Mixed venous oxygen saturation reacted faster to changes than did CO;both were measured via the Swan-Ganz catheter.Conclusions : In many animal studies, the use of Swan-Ganz catheters is suitable;however, in experiments with sudden hemodynamic instability, the flow probe is the most advantageous method for measuring CO.展开更多
Acute myocardial infarction(AMI)with left ventricular(LV)dysfunction patients,the most common cause of cardiogenic shock(CS),have acutely deteriorating hemodynamic status.The frequent use of vasopressor and inotropic ...Acute myocardial infarction(AMI)with left ventricular(LV)dysfunction patients,the most common cause of cardiogenic shock(CS),have acutely deteriorating hemodynamic status.The frequent use of vasopressor and inotropic pharmacologic interventions along with mechanical circulatory support(MCS)in these patients necessitates invasive hemodynamic monitoring.After the pivotal Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial failed to show a significant improvement in clinical outcomes in shock patients managed with a pulmonary artery catheter(PAC),the use of PAC has become less popular in clinical practice.In this review,we summarize currently available literature to summarize the indications,clinical relevance,and recommendations for use of PAC in the setting of AMI-CS.展开更多
文摘Background : In many animal experiments, it is vital to detect sudden changes in cardiac output(CO). This porcine study compared CO that was measured with a SwanGanz pulmonary catheter with the gold standard(which was a transit-time flow probe around the pulmonary artery) during interventions that caused hemodynamic instability.Methods : In one series, 7 pigs were exposed to sudden changes in CO. In another series, 9 pigs experienced more prolonged changes in CO. All the pigs had a Swan-Ganz catheter placed into the pulmonary artery and a flow probe around the pulmonary artery. Adrenaline infusion and controlled hemorrhage were used to increase and decrease CO, respectively. The measurements of CO before and after each intervention were compared for correlation, agreement, and the time delay that it took each method to detect at least a 30% change in CO. A Bland– Altman test was used to identify correlations and agreements between the methods.Results : In the first series, there was a delay of 5– 7 min for the Swan Ganz catheter to register a 30% change in cardiac output, compared with the flow probe. However,during prolonged changes in CO in the second series, there was a good correlation between the 2 methods. Mixed venous oxygen saturation reacted faster to changes than did CO;both were measured via the Swan-Ganz catheter.Conclusions : In many animal studies, the use of Swan-Ganz catheters is suitable;however, in experiments with sudden hemodynamic instability, the flow probe is the most advantageous method for measuring CO.
文摘Acute myocardial infarction(AMI)with left ventricular(LV)dysfunction patients,the most common cause of cardiogenic shock(CS),have acutely deteriorating hemodynamic status.The frequent use of vasopressor and inotropic pharmacologic interventions along with mechanical circulatory support(MCS)in these patients necessitates invasive hemodynamic monitoring.After the pivotal Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial failed to show a significant improvement in clinical outcomes in shock patients managed with a pulmonary artery catheter(PAC),the use of PAC has become less popular in clinical practice.In this review,we summarize currently available literature to summarize the indications,clinical relevance,and recommendations for use of PAC in the setting of AMI-CS.
