Journal of cardiothoracic and vascular anesthesia · 2025
Prognostic Value of Noninvasive Central Blood Pressure and Arterial Stiffness in Hemodynamic Shock.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Markakis Konstantinos, Georgianou Eleni, Pagonas Nikolaos, Bertram Sebastian, Seidel Maximilian, Babel Nina, Westhoff Timm H, Seibert Felix S
Аннотация
OBJECTIVES: Elevated central blood pressure (BP) and arterial stiffness are risk factors for cardiovascular mortality. However, their prognostic value in patients with hemodynamic shock has not been studied broadly. Evolved BP monitoring devices enable the noninvasive assessment of central BP and arterial stiffness. The objective of this study was to evaluate the prognostic value of central BP and arterial stiffness measurements, delivered by 2 noninvasive devices, in patients with septic or cardiogenic shock admitted to the intensive care unit.
DESIGN: This is a monocenter, prospective, cohort study.
SETTING: This study was conducted in a tertiary university hospital.
PARTICIPANTS: We enrolled 57 patients who were admitted to the intensive care unit with septic or cardiogenic shock.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Central BP and arterial stiffness indices like pulse wave velocity (PWV) and Aix were recorded with a Mobil-o-Graph 24h PWA and SphygmoCor XCEL. Age, catecholamine dosage, resuscitation incidence before inclusion, C-reactive protein, leukocytes, and creatinine were recorded as possible confounders. With regard to the confounders, central systolic BP measured in the first 24 hours, was predictive of 6-month mortality (odds ratio, 0.9; p < 0.05). Aix, recorded by Mobil-o-Graph 24h PWA, was associated with death in the first 14 days (odds ratio, 1.11; p = 0.03). An increased PWV was not associated with adverse outcomes.
CONCLUSIONS: Low central BP and increased Aix were linked to a higher mortality in shock patients. PWV had no prognostic value.
DESIGN: This is a monocenter, prospective, cohort study.
SETTING: This study was conducted in a tertiary university hospital.
PARTICIPANTS: We enrolled 57 patients who were admitted to the intensive care unit with septic or cardiogenic shock.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Central BP and arterial stiffness indices like pulse wave velocity (PWV) and Aix were recorded with a Mobil-o-Graph 24h PWA and SphygmoCor XCEL. Age, catecholamine dosage, resuscitation incidence before inclusion, C-reactive protein, leukocytes, and creatinine were recorded as possible confounders. With regard to the confounders, central systolic BP measured in the first 24 hours, was predictive of 6-month mortality (odds ratio, 0.9; p < 0.05). Aix, recorded by Mobil-o-Graph 24h PWA, was associated with death in the first 14 days (odds ratio, 1.11; p = 0.03). An increased PWV was not associated with adverse outcomes.
CONCLUSIONS: Low central BP and increased Aix were linked to a higher mortality in shock patients. PWV had no prognostic value.