Left ventricular assist devices (LVADs) are increasingly used in patients with end-stage heart failure (HF). There is a significant risk of HF admissions and hemocompatibility-related adverse events that can be minimized by optimizing the LVAD support. Invasive hemodynamic assessment, which is currently underutilized, allows personalization of care for patients with LVAD, and may decrease the need for recurrent hospitalizations. It also aids in triaging patients with persistent low-flow alarms, evaluating reversal of pulmonary vasculature remodeling, and assessing right ventricular function. In addition, it can assist in determining the precipitant for residual HF symptoms and physical limitation during exercise and is the cornerstone of the assessment of myocardial recovery. This review provides a comprehensive approach to the use of invasive hemodynamic assessments in patients supported with LVADs.
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http://dx.doi.org/10.1016/j.jchf.2023.08.019 | DOI Listing |
Anaesth Crit Care Pain Med
December 2024
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona (UB), Barcelona, Spain; Respiratory Intensive Care Unit, Pneumology, Respiratory Institute, Hospital Clinic of Barcelona, Barcelona, Spain. Electronic address:
Background: Driving pressure is thought to determine the effect of low tidal ventilation on survival in patients with acute respiratory distress syndrome. The leading cause of mortality in these patients is non-pulmonary multiorgan dysfunction, which is believed to worsen due to the biological response to mechanical ventilation (biotrauma). Therefore, we aimed to analyze the association between driving pressure, biotrauma, and non-pulmonary multiorgan dysfunction.
View Article and Find Full Text PDFResuscitation
December 2024
Cardiovascular Division, University of Minnesota, Minneapolis, MN, U.S.A; Center for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, U.S.A. Electronic address:
Introduction: The haemodynamic effects veno-arterial extracorporeal membrane oxygenation (VA-ECMO) remain inadequately understood. We investigated invasive left ventricular (LV) haemodynamics in patients who underwent treatment with an intensive care strategy involving extracorporeal cardiopulmonary resuscitation (ECPR).
Methods: We conducted invasive haemodynamic assessments on 15 patients who underwent ECPR and achieved return of spontaneous circulation.
EBioMedicine
December 2024
Department of Engineering Physics, Polytechnique Montréal, Montreal, Canada; Montreal Heart Institute, Montreal, Canada. Electronic address:
Background: Haemodynamic changes occur in stroke and neurodegenerative diseases. Developing imaging techniques allowing the in vivo visualisation and quantification of cerebral blood flow would help better understand the underlying mechanism of these cerebrovascular diseases.
Methods: 3D ultrasound localization microscopy (ULM) is a recently developed technology that can map the microvasculature of the brain at large depth and has been mainly used until now in rodents.
J Artif Organs
December 2024
Division of Cardiology, Ospedale Civile Maggiore Borgo Trento, Piazzale Stefani, Verona, (VR), Italy.
Cardiac surgery patients are potentially exposed to an acute inflammatory host response with a huge release of both pro- and anti-inflammatory cytokines both through intrinsic (e.g., tissue damage, endothelial injury) and extrinsic (e.
View Article and Find Full Text PDFBMC Anesthesiol
December 2024
Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Aswan University, Aswan, Egypt.
Background: There is no significant evidence verifying the efficacy of liberal versus conservative oxygen therapy on hemodynamics in patients with sepsis. We investigated how liberal and conservative oxygen therapy influenced stroke volume, cardiac output, and vasopressor needs in patients with sepsis undergoing mechanical ventilation.
Methods: This randomized clinical trial included 106 patients with an admission diagnosis of infection, a Sequential Organ Failure Assessment (SOFA) score of two points or higher and required invasive mechanical ventilation for at least 72 h.
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