Echocardiographic Assessment of Pulmonary Artery Pressure in Ventilated Patients
Author Information
Author(s): Philippe Vignon, Ali AitHssain, Bruno François, Pierre-Marie Preux, Nicolas Pichon, Marc Clavel, Jean-Pierre Frat, Hervé Gastinne
Primary Institution: Dupuytren Teaching Hospital
Hypothesis
Can transoesophageal echocardiography (TEE) Doppler accurately predict invasive pulmonary artery occlusion pressure (PAOP) ≤ 18 mmHg in ventilated patients?
Conclusion
TEE accurately predicts invasive PAOP ≤ 18 mmHg in ventilated patients, enhancing its diagnostic value for those with suspected acute lung injury or acute respiratory distress syndrome.
Supporting Evidence
- Mitral E/A ≤ 1.4, pulmonary vein S/D > 0.65, and systolic fraction > 44% best predicted an invasive PAOP ≤ 18 mmHg.
- Lateral E/E' ≤ 8.0 or E/Vp ≤ 1.7 predicted a PAOP ≤ 18 mmHg with high sensitivity and specificity.
- The study included 88 ventilated patients, with 70 having PAOP ≤ 18 mmHg.
Takeaway
Doctors can use a special ultrasound test called TEE to see if a patient's heart is under too much pressure, which helps them treat breathing problems better.
Methodology
The study compared TEE Doppler parameters to invasive PAOP measurements in 88 ventilated patients over two protocols.
Potential Biases
Potential bias due to the study's design and the exclusion of certain patient groups.
Limitations
The study's reliance on invasive PAOP measurements, which have known limitations, and the exclusion of patients with non-sinus rhythm or significant valvulopathy.
Participant Demographics
Mean age 63 ± 14 years; 59 men; 72% receiving vasopressor therapy.
Statistical Information
P-Value
0.53
Confidence Interval
95% CI: 0.70–0.92
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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