Department of Intensive Care, Prince of Wales Hospital, Sydney, NSW, 2031, Australia.
The University of New South Wales, Sydney, NSW, 2052, Australia.
J Cardiovasc Transl Res. 2022 Dec;15(6):1455-1463. doi: 10.1007/s12265-022-10265-6. Epub 2022 May 11.
The absence of an accepted gold standard to estimate volume status is an obstacle for optimal management of left ventricular assist devices (LVADs). The applicability of the analogue mean systemic filling pressure (Pmsa) as a surrogate of the mean circulatory pressure to estimate volume status for patients with LVADs has not been investigated. Variability of flows generated by the Impella CP, a temporary LVAD, should have no physiological impact on fluid status. This translational interventional ovine study demonstrated that Pmsa did not change with variable circulatory flows induced by a continuous flow LVAD (the average dynamic increase in Pmsa of 0.20 ± 0.95 mmHg from zero to maximal Impella flow was not significant (p = 0.68)), confirming applicability of the human Pmsa equation for an ovine LVAD model. The study opens new directions for future translational and human investigations of fluid management using Pmsa for patients with temporary LVADs.
目前还没有公认的金标准来评估血容量状态，这成为了左心室辅助装置（LVAD）优化管理的障碍。模拟平均全身充盈压（Pmsa）作为平均循环压力的替代指标，用于评估 LVAD 患者的血容量状态的适用性尚未得到研究。Impella CP（一种临时 LVAD）产生的流量变化不应对液体状态产生生理影响。这项转化性羊研究表明，Pmsa 不会随连续血流 LVAD 引起的循环流量变化而变化（从 0 到最大 Impella 流量，Pmsa 的平均动态增加仅为 0.20 ± 0.95 mmHg，无显著差异（p = 0.68）），证实了人类 Pmsa 方程在羊 LVAD 模型中的适用性。这项研究为使用 Pmsa 对接受临时 LVAD 的患者进行液体管理的未来转化和人体研究开辟了新的方向。
