Hemodynamic Parameters of Forrester et al and Risk after Acute Myocardial Infarction

 

Patient findings:

(1) pulmonary congestion: rales, abnormal chest X-rays (differential flow to the upper pulmonary lobes, blurring of pulmonary vascular margins, perihilar haziness)

(2) peripheral hypoperfusion: hypotension, tachycardia, confusion, cyanosis, oliguria, decreased skin temperature

 

Hemodynamic testing:

(1) pulmonary capillary wedge pressure using Swan-Ganz catheter

(2) cardiac output, divided by the body surface area, to generate the cardiac index

pulmonary capillary wedge pressure in mm Hg	cardiac index in liters/min per meter squared	mortality
<= 18	>= 2.2	3%
> 18	>= 2.2	9%
<= 18	< 2.2	23%
> 18	< 2.2	51%

 

Interventions that improve the hemodynamic findings (increase cardiac index, reduce pulmonary capillary wedge pressure) reduce mortality.