Is There a Role for Invasive Hemodynamic Monitoring in Acute Heart Failure Management?

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• 作者：Daniel De Backer
• 关键词：Pulmonary artery catheter ; Transpulmonary thermodilution ; Cardiac output ; Cardiac function ; Tissue perfusion ; Respiratory failure ; Circulatory failure
• 刊名：Current Heart Failure Reports
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：12
• 期：3
• 页码：197-204
• 全文大小：287 KB
• 参考文献：Papers of particular interest, published recently, have been highlighted as: 鈥?Of importance 鈥⑩€?Of major importance1.De Backer D, Fagnoul D, Herpain A. The role of invasive techniques in cardiopulmonary evaluation. Curr Opin Crit Care. 2013;19(3):228鈥?3.View Article PubMed
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• 作者单位：Daniel De Backer (1)
  
  1. Department of Intensive Care, CHIREC Hospitals, Universit茅 Libre de Bruxelles, Rue Wayez 35, B-1420 Braine L鈥橝lleud, Brussels, Belgium
  
• 刊物主题：Cardiology; Cardiac Surgery; Vascular Surgery; Internal Medicine; Imaging / Radiology;
• 出版者：Springer US
• ISSN：1546-9549

文摘

The place of invasive hemodynamic monitoring in patients with acute heart failure is still debated, even though frequently used. Invasive techniques, which include the pulmonary artery catheter and transpulmonary thermodilution, provide important information on cardiac output and intravascular pressures or volume. These techniques should be used in combination with echocardiography and allow nurse-driven semicontinuous hemodynamic monitoring. These techniques are useful not only in the diagnosis of circulatory or respiratory failure but also for the evaluation of the effects of therapies. Admittedly, large-scale randomized trials failed to demonstrate a survival benefit with the pulmonary artery catheter (and were even not yet performed with transpulmonary thermodilution). However, these trials may be subjected to selection bias, as patients from recruiting centers not included in the trial but receiving the pulmonary artery catheter were more severe and had higher mortality rates than patient included in the trial. Hence, invasive techniques may still have a place in selected patients with acute circulatory failure and especially in the most severe cases.