Haemodynamic monitoring in acute heart failure – what you need to know

Karolina Jasińska-Gniadzik; Piotr Szwed; Aleksandra Gasecka; Mateusz Zawadka; Marcin Grabowski; Arkadiusz Pietrasik

doi:10.5114/aic.2022.118524

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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abstract:

Review paper

Haemodynamic monitoring in acute heart failure – what you need to know

Karolina Jasińska-Gniadzik

¹

,

Piotr Szwed

¹

,

Aleksandra Gasecka

¹

,

Mateusz Zawadka

²

,

Marcin Grabowski

¹

,

Arkadiusz Pietrasik

¹

1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
2nd Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland

Adv Interv Cardiol 2022; 18, 2 (68): 90–100

DOI: https://doi.org/10.5114/aic.2022.118524

Online publish date: 2022/08/20

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Acute heart failure (AHF) is a sudden, life-threatening condition, defined as a gradual or rapid onset of symptoms and/or signs of HF. AHF requires urgent medical attention, being the most frequent cause of unplanned hospital admission in patients above 65 years of age. AHF is associated with a 4–12% in-hospital mortality rate and a 21–35% 1-year mortality rate post-discharge. Considering the serious prognosis in AHF patients, it is very important to understand the mechanisms and haemodynamic status in an individual AHF patient, thus preventing end-organ failure and death. Haemodynamic monitoring is a serial assessment of cardiovascular function, intended to detect physiologic abnormalities at the earliest stages, determine which interventions could be most effective, and provide the basis for initiating the most appropriate therapy and evaluate its effects. Over the past decades, haemodynamic monitoring techniques have evolved greatly. Nowadays, they range from very invasive to non-invasive, from intermittent to continuous, and in terms of the provided parameters. Invasive techniques contain pulmonary artery catheterization and transpulmonary thermodilution. Minimally invasive techniques include oesophageal Doppler and noncalibrated pulse wave analysis. Non-invasive techniques contain echocardiography, bioimpedance, and bioreactance techniques as well as non-invasive pulse contour methods. Each of these techniques has specific indications and limitations. In this article, we aimed to provide a pathophysiological explanation of the physical terms and parameters used for haemodynamic monitoring in AHF and to summarize the working principles, advantages, and disadvantages of the currently used methods of haemodynamic monitoring.

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Haemodynamic monitoring in acute heart failure – what you need to know

Karolina Jasińska-Gniadzik 1 , Piotr Szwed 1 , Aleksandra Gasecka 1 , Mateusz Zawadka 2 , Marcin Grabowski 1 , Arkadiusz Pietrasik 1

acute heart failure, haemodynamic monitoring, intensive care

Karolina Jasińska-Gniadzik

¹

,

Piotr Szwed

¹

,

Aleksandra Gasecka

¹

,

Mateusz Zawadka

²

,

Marcin Grabowski

¹

,

Arkadiusz Pietrasik

¹