Non-Invasive Hemodynamic Measurements for Acute Decompensated Heart Failure

Abstract

Background: Hemodynamic invasive monitoring has been proved without benefit in management of decompesated heart failure. However non-invasive hemodynamic modelflow method has not been assessed in management of decompesated severe heart failure. The objective of this study was to compare the non-invasive modelflow method of hemodynamic monitoring with the thermodilution pulmonary artery catheter method in hospitalized patients by decompensated severe heart failure. Methods: Hospitalized patients for acute decompensated heart failure were included. The patients had ejection fraction < 0.45, in use of inotropes for low cardiac output and underwent to invasive pulmonary artery catheterization to hemodynamic measurement. Simultaneously non-invasive modelflow method hemodynamic (Nexfin™, Bmeye) was done for each patient. For same patient hemodynamic measurements in different day were considered separate. The data were analyzed by Bland-Altman agreement method and correlation Pearson or Spearman method. P < 0.05 was significant. Results: Twenty eight patients were included and 47 simultaneous hemodynamic measurements were done. For cardiac index, the correlation coefficient was 0.281 (P=0.05) and for indexed systemic vascular resistance was 0.104 (P=0.48). the Bland-Altman plot show the agreement between the methods. Conclusion: In decompensated severe heart failure with current use of inotropes non-invasive hemodynamic modelflow method measurement was in agreement with invasive measurement. The non-invasive modelflow method could be useful for heart failure management.