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Table 2 Clinical meanings and usefulness of various PAC-derived haemodynamic variables in different clinical conditions

From: Which cardiac surgical patients can benefit from placement of a pulmonary artery catheter?

Clinical scenario Useful PAC-derived indices Clinical meaning/uses
Impaired left ventricular systolic function CI Clinical target (i.e. >2.4 l/min per m2)
   Monitor effects of inotropic therapy
   Monitor fluid responsiveness
  PCWP Left ventricular filling pressure
   Monitor fluid responsiveness
   Monitor effects of inotropic/vasodilating therapy
  PAP Check for the presence of pre-capillary or post-capillary pulmonary hypertension
   Possible use as continuous index of left ventricular preload
  SVR Check for the presence of a peripheral vasoconstrictive status
  SvO2 Monitor the effects of vasodilating therapies
   Clinical target (i.e. >75%)
   Check matching of DO2 to VO2
   Monitor adequacy of CI
   Monitor the effects of drug and fluid administration
Impaired right ventricular function CI As above
  SvO2 As above
  PCWP As above
  CVP RV preload and venous system filling status
   Monitor fluid responsiveness
  PVR Check for the presence of pulmonary hypertension
   Guide inhaled nitric oxide therapy and ventilator settings
  Right ventricular EF RV contractility index
  RV EDV RV preload
Left ventricular diastolic dysfunction CI As above
  SvO2 As above
  PCWP As above, with particular respect to fluid responsiveness and fluid administration
   Follow changes from pseudo-normalization to restrictive pattern
Acute ventricular septal defect CI Suggestive for VSD reopening after correction if increased
  SvO2 Diagnostic for VSD reopening after correction if increased
LVAD CVP Right ventricular preload and general filling status of the patient
  PVR Presence of pre-capillary pulmonary hypertension
   Need for iNO therapy and monitor the effects
  Right ventricular EF Right ventricular contractility and preload
  SvO2 Adequacy of LVAD flow to the metabolic needs
  1. CI, cardiac index; CVP, central venous pressure; DO2, oxygen delivery; EF, ejection fraction; LVAD, left ventricular assist device; PAC, pulmonary artery catheter; PAP, pulmonary artery pressure; PCWP, pulmonary capillary wedge pressure; PVR, pulmonary vascular resistances; RVEDV; right ventricle end-diastolic volume; SvO2, mixed venous oxygen saturation; SVR, systemic vascular resistances; VO2, oxygen consumption.