Pulmonary artery catheter

Manufactured by Edwards Lifesciences

Sourced in United States

The Pulmonary Artery Catheter is a medical device designed to measure various hemodynamic parameters, including cardiac output, central venous pressure, and pulmonary artery pressure. It is commonly used in critical care and surgical settings to monitor and manage the patient's cardiovascular function.

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Lab products found in correlation

Cs 200, by Schiller (1 mentions) Intellivue mx800, by Philips (1 mentions)

11 protocols using pulmonary artery catheter

Hemodynamic Monitoring and Vasoactive Support

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Subject demographics, pre-operative risk score (euroSCORE II) and medical history were collected during initial screening. Cardiac index (CI), central venous pressure (CVP), pulmonary artery pressure (PAP), and mixed venous oxygen saturation (SvO₂) were continuously monitored by pulmonary artery catheter (Edwards Lifesciences LLC, Irvine, CA, USA). Arterial blood pressure was measured continuously using a standard invasive arterial line. Systemic hemodynamic data, vasopressor infusion doses, and mixed venous oxygen saturation were recorded at baseline then every 3 min for 30 min after application of the topical nitroglycerin solution³⁵. The vasopressor-inotrope score (VIS) was calculated to summarize the degree of post-operative vasoactive support was required at the time of the study^{36 (link)}. Norepinephrine equivalents were calculated for each patient at each time point^{37 (link)}.

Greenwood J.C., Talebi F.M., Jang D.H., Spelde A.E., Tonna J.E., Gutsche J.T., Horak J., Acker M.A., Kilbaugh T.J., Shofer F.S., Augoustides J.G., Bakker J., Brenner J.S., Muzykantov V.R, & Abella B.S. (2022). Topical nitroglycerin to detect reversible microcirculatory dysfunction in patients with circulatory shock after cardiovascular surgery: an observational study. Scientific Reports, 12, 15257.

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Porcine Model of Arrhythmias and Monitoring

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This study was approved by the Institutional Animal Care and Use Committee at the University of Pittsburgh and all experiments were performed in accordance with the relevant guidelines and regulations. Yorkshire swine (81–85 kg, 6 –12 months) fasted for 24 hours were placed under endotracheal anesthesia and given amiodarone to prevent fatal ventricular arrhythmias common in the porcine model (25 (link), 26 ) following by sterile surgical prep. Hemodynamic monitoring was initiated by carotid and femoral arterial lines, as well as placement of a pulmonary artery catheter (Edwards Lifesciences, Irvine, CA). Baseline contrasted angiograms, mean arterial pressure (MAP), cardiac output (CO) and central venous pressure (CVP) were recorded. Serum chemistry values and arterial blood gas values were assessed pre-operatively and then every 24 hours, or at time of removal from the study as highlighted under Post Agonal Resuscitation below.

Go C., Elsisy M., Frenz B., Moses J., Tevar A.D., Demetris A.J., Chun Y, & Tillman B.W. (2021). A Retrievable, Dual Chamber Stent Protects Against Warm Ischemia of Donor Organs in a Model of Donation After Circulatory Death. Surgery, 171(4), 1100-1107.

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Integrative Cardiopulmonary Exercise Testing

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All patients underwent CPET with respiratory gas analysis (CS-200, Schiller). Exercise was performed on a semi-supine bicycle ergometer (ErgoLine) with a continuous ramp protocol aimed for a total exercise duration of 10–12 min. In all patients, echocardiography data was simultaneously collected during 2 stage holds, at submaximal level (aerobic threshold) and at peak exercise, as described previously (13 (link), 14 (link)). In the exRHC cohort, additionally a pulmonary artery catheter (Edwards Lifesciences) was placed under fluoroscopic guidance at the catheterization lab before start of the CPET and the right radial artery was cannulated with a 5F arterial catheter, to obtain arterial and mixed venous blood gas samples and measure PAWP.
Invasive, CPET, and echocardiographic measurements are described in detail in the Supplementary Methods. For echocardiography, peak mitral systolic annular velocity (S') was measured using color tissue Doppler imaging (TDI) at the septal mitral annulus (Supplementary Figure 1). E/e' was also measured at the septal mitral annulus. Colloid enhancement of the tricuspid insufficiency signal was systematically employed to measure systolic pulmonary artery pressure (sPAP), as previously described (15 (link)). Cardiac output (CO) was measured using the left ventricular outflow tract method.

Verwerft J., Verbrugge F.H., Claessen G., Herbots L., Dendale P, & Gevaert A.B. (2022). Exercise Systolic Reserve and Exercise Pulmonary Hypertension Improve Diagnosis of Heart Failure With Preserved Ejection Fraction. Frontiers in Cardiovascular Medicine, 9, 814601.

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Comprehensive Perioperative Hemodynamic Monitoring

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Systemic hemodynamic data, perfusion data, and blood gas measurements will be collected upon ICU admission, then hourly during the first 6 hours of postoperative care. Cardiac output (CO), cardiac index (CI), central venous pressure (CVP), pulmonary artery pressure (PAP), and mixed venous oxygen saturation (SvO₂) will be monitored continuously using a pulmonary artery catheter (Edwards Lifesciences LLC, Irvine, CA, USA). Arterial blood pressure will be measured using a standard invasive arterial line. Intraoperative and post-operative administration of blood products, intravenous fluids, vasoactive agents (vasopressor and inotropes), and sedatives will be recorded at each time point.

Greenwood J.C., Talebi F.M., Jang D.H., Spelde A.E., Kilbaugh T.J., Shofer F.S., Acker M.A., Augoustides J.G., Bakker J., Meyer N.J., Brenner J.S., Muzykantov V.R, & Abella B.S. (2022). Protocol for the MicroRESUS study: The impact of circulatory shock and resuscitation on microcirculatory function and mitochondrial respiration after cardiovascular surgery. PLoS ONE, 17(8), e0273349.

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Intraoperative Hemodynamic Monitoring in Cardiac Surgery

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All patients received standard monitoring during the surgery, including electrocardiography and invasive blood pressure, oxygen saturation, HR, and bispectral index (BIS, Aspect Medical System, Minneapolis, MN, USA) assessments. General anesthesia was induced with intravenous midazolam (0.05 mg/kg), fentanyl (8 μg/kg), etomidate (0.3 mg/kg), and cisatracurium (0.2 mg/kg) to facilitate tracheal intubation. A pulmonary artery catheter (Edwards Lifesciences, Irvine, CA, USA) was inserted, and three measurement valures of pulmonary capillary wedge pressure (PCWP) were recorded at the end of the trial. The mean of the three PCWP measurement values was applied for the analysis. Subsequently, a TEE probe with a live three-dimensional acquisition capability (X2-7t, Philips, Amsterdam, the Netherlands) was inserted. Another 5 μg/kg of fentanyl was administered before the incision.
In the AS group, anesthesia was maintained with sevoflurane (0.7 to 2.0 minimum alveolar concentration), supplemented by remifentanil and cisatracurium, targeting a BIS of 40–60. In the AA group, the propofol-based TIVA [3–12 mg/(kg∙h)] was used with remifentanil and cisatracurium, aiming for the same BIS range.

Gong C., Zhou X., Fang Y., Zhang Y., Zhu L, & Ding Z. (2023). Effects of sevoflurane on left ventricular function by speckle-tracking echocardiography in coronary bypass patients: A randomized trial. Journal of Biomedical Research, 38(1), 76-86.

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Porcine model for cardiac monitoring

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This study approved by the Institutional Animal Care and Use Committee at the University of Pittsburgh. Yorkshire cross swine (77–87 kg) were sedated followed by endotracheal anesthesia with isoflurane. Amiodarone 10 mg/kg was administered to prevent fatal ventricular arrhythmias common in the porcine model.^{14 (link),15} Hemodynamic monitoring was initiated by carotid and femoral arterial lines, as well as a pulmonary artery catheter (Edwards Lifesciences, Irvine, CA). Baseline angiograms, neurologic monitoring, mean arterial pressure (MAP), cardiac output (CO), and central venous pressure (CVP) were recorded.

Go C., Elsisy M., Chun Y., Thirumala P.D., Clark W.W., Cho S.K., Demetris A.J, & Tillman B.W. (2020). A three-tier Rescue stent improves outcomes over balloon occlusion in a porcine model of noncompressible hemorrhage. The journal of trauma and acute care surgery, 89(2), 320-328.

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Rodent Traumatic Brain Injury Model

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The right femoral artery was exposed via a cut down technique and was cannulated with a 5-Fr 11-cm catheter. The arterial line was used for blood pressure monitoring and blood draws for laboratory measurements. A 4 cm low midline laparotomy was performed, through which a cystostomy tube was placed. The right external jugular vein was accessed percutaneously for sheath placement, and a pulmonary artery catheter (Edwards Life Sciences, Irvine, CA) was floated for cardiac output monitoring. The animal was flipped prone and remained there for the remainder of the experiment. The head was secured in a stereotactic frame. A U-shaped incision was made on the top of the skull and skin flap raised to expose the bregma. A 21 mm burr hole was made just anterior and to the right of the bregma to expose the dura for TBI. A 5 mm burr hole was made anterior and to the left of the bregma for placement of an intracranial pressure (ICP) monitor. An intravenous infusion of normal saline at 50 mL/hour was given to all the animal as maintenance fluids for the entire experiment.

Biesterveld B.E., Pumiglia L., Iancu A., Shamshad A.A., Remmer H.A., Siddiqui A.Z., O’Connell R.L., Wakam G.K., Kemp M.T., Williams A.M., Pai M.P, & Alam H.B. (2020). Valproic Acid Treatment Rescues Injured Tissues After Traumatic Brain Injury. The journal of trauma and acute care surgery, 89(6), 1156-1165.

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Hemodynamic Assessment During Gradual Ischemia

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A total of 15 experiments were conducted. Three experiments were excluded due to fatal complication in the surgery before any data were gathered. One pilot experiment was excluded due to technical issues. In 8 of the successful experiments, the animals were first subject to loading and unloading of blood volume, as part of another experiment protocol. As part of this other protocol we performed additional instrumentation including placement of a pulmonary artery catheter (Edwards Lifesciences Corporation, Irvine, CA, USA) through an introducer in the right jugular vein, PiCCO catheter (PV 2025L20, PULSIOCATH; Pulsion Medical Systems, Munich, Germany) inserted in the femoral artery, and four additional sonomicrometry sensors placed in the apex, base, anterior, and posterior regions of the LV. In 2 of the pilot experiments the flow of blood supply to the LAD was controlled by occluding the LAD and bypassing it with the left internal mammary artery. The amount of flow going to the LAD was then controlled by an adjustable occluder and the blood flow was measured using transit time flowmetry (Transsonic Systems Inc. Ithaca, NY, USA). Ischemia in these two experiments were gradually induced over several minutes.

Krogh M.R., Halvorsen P.S., Elle O.J., Bergsland J, & Remme E.W. (2019). Dynamic gravity compensation does not increase detection of myocardial ischemia in combined accelerometer and gyro sensor measurements. Scientific Reports, 9, 2671.

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Perioperative Hemodynamic Monitoring Protocol

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Cardiac output, central venous pressure, pulmonary artery pressure, and mixed venous oxygen saturation (SvO₂) were measured continuously using a pulmonary artery catheter (Edwards Lifesciences LLC, Irvine, CA). Arterial blood pressure was measured using a standard invasive arterial line. Blood gas samples were drawn from an arterial line into a commercial, pre-heparinized 1-mL arterial blood sampler, then immediately analyzed with an ABL90 FLEX automatic blood gas analyzer (Radiometer America Inc., Brea, CA). Sequential organ failure assessment (SOFA) scores were calculated 24 and 48 hours after surgery.^{14 (link)}

Greenwood J.C., Jang D.H., Hallisey S.D., Gutsche J.T., Horak J., Acker M.A., Bermudez C.A., Zhou V.L., Chatterjee S., Shofer F.S., Kilbaugh T.J., Augoustides J.G., Meyer N.J., Bakker J, & Abella B.S. (2020). Severe Impairment of Microcirculatory Perfused Vessel Density Is Associated With Postoperative Lactate and Acute Organ Injury After Cardiac Surgery. Journal of cardiothoracic and vascular anesthesia, 35(1), 106-115.

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Targeted Hypothermia Protocol

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Animals were cooled by circulating cold water (5°C) in combination with ice slush to a level of two-thirds of the animal immersed in a waterproof reservoir mounted on the top of the operating table. The head was placed on a cushion and not immersed in cold water or covered with ice slush. Blood temperature was monitored via the thermistor on the pulmonary artery catheter (Edwards Lifesciences, Irvine, CA, United States). After reaching a blood core temperature of 28°C, the cold water was drained from the reservoir, and subsequently the core temperature dropped to 27°C. Careful warming was performed by positioning the operation lamps closer to the animal to prevent a further drop in core temperature.

Valkov S., Nilsen J.H., Mohyuddin R., Schanche T., Kondratiev T., Sieck G.C, & Tveita T. (2022). Autoregulation of Cerebral Blood Flow During 3-h Continuous Cardiopulmonary Resuscitation at 27°C. Frontiers in Physiology, 13, 925292.

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