Using dP/dt Contour Analysis to Wean IABP/Inotropic Support in a Cardiogenic Shock Patient.

BACKGROUND

dP/dt, the rate of ventricular pressure rise during systole, reflects myocardial contractility and is traditionally measured invasively or by echocardiography. New technologies derive it from real-time peripheral arterial waveforms, offering a minimally invasive surrogate, though intensive care unit use remains limited because of preload/afterload sensitivity and minimal investigative studies.

SUMMARY: We report, to our knowledge, the first clinical case using continuous arterial dP/dt pressure waveform analysis (PWA) in the intensive care unit to guide real-time management in cardiovascular (CV) assessment of a patient with Society for Cardiovascular Angiography and Interventions (SCAI) stage E cardiogenic shock.

DISCUSSION: As illustrated in our patient, dP/dt PWA has potential as an additional CV parameter to support inotrope and device weaning decisions.

NOVELTY OF SUBMISSION: Radial PWA-derived dP/dt offers an added means to monitor CV performance, with evolving AI-driven optimization enhancing its reliability for estimating myocardial contractility.

TAKE-HOME MESSAGE: dP/dt-radial PWA contour analysis has viable potential in dynamic CV assessment of myocardial recovery (alongside other established parameters) in critical care settings.