Differences in Swan-Ganz Hemodynamics from Catheterization Lab Insertion to the Cardiac Care Unit: A Prospective Study

Abstract

Purpose Invasive hemodynamic monitoring with Swan-Ganz catheters (SGC) provides clinical information that can help guide heart failure management and inform decisions regarding advanced heart failure therapies. However, measurements in the cardiac catheterization laboratory (CCL) can potentially be affected by anxiety, stress, and colder temperatures. To address the magnitude of this effect, we investigated the magnitude of variation in hemodynamics between the CCL and the cardiac care unit (CCU). Methods We prospectively enrolled patients who underwent SGC placement in the CCL and then were moved to the cardiac care unit (CCU) for continuous hemodynamic monitoring. Hemodynamic measurements obtained in CCL were compared to on arrival to the CCU before the initiation of additional medical interventions. Results Data was obtained from 53 patients with heart failure [58.8 ± 13 years; 17% female; LVEF 20% ± 12%] who had leave-in SGCs placed since April 2018. Compared to the CCU, patients in the CCL were found to have higher biventricular filling pressures, systemic vascular resistance (p pulmonary vascular resistance (p Conclusion Invasive hemodynamic measurements obtained from patients with heart failure in the CCL are significantly worse than those obtained hours later in the CCU environment. In patients that have unfavorable hemodynamics in the CCL, there may be utility in reassessing parameters in an inpatient setting to optimize patient management.