Hemodynamic readings in a patient with a mechanical left ventricular assist device (VAD) can help identify problems resulting in inadequate pumping. These can help guide the interventions to correct the problem.
When the pumping by the left ventricular assist device is adequate, then the following readings are seen:
|
Systolic Aortic Blood Pressure mm Hg |
Cardiac Output in L per min per square meter |
Central Venous Pressure in mm Hg |
Left Atrial Pressure in mm Hg |
|
>= 90 mm Hg |
> 2.0 |
< 20 mm Hg |
< 10 mm Hg |
The presence of systolic aortic hypotension (< 90 mm Hg) and decreased cardiac output (<= 2 L per min per square meter BSA) indicates that the VAD pumping is inadequate.
|
Central Venous Pressure in mm Hg |
Left Atrial Pressure in mm Hg |
Diagnosis |
|
< 15 mm Hg |
< 10 mm Hg |
hypovolemia |
|
> 20 mm Hg |
< 10 mm Hg |
right ventricular failure |
|
< 20 mm Hg |
> 20 mm Hg |
inlet cannula obstruction |
Several combinations of readings are not covered by this table. The following represent these readings and some possible explanations that assume combinations of these basic patterns.
|
Central Venous Pressure in mm Hg |
Left Atrial Pressure in mm Hg |
Possible Diagnosis |
|
15 - 20 mm Hg |
< 10 mm Hg |
hypovolemia and right ventricular failure |
|
< 20 mm Hg |
10 - 20 mm Hg |
hypovolemia and inlet cannula obstruction |
|
>= 20 mm Hg |
10 - 20 mm Hg |
inlet cannula obstruction and right ventricular failure |
|
>= 20 mm Hg |
> 20 mm Hg |
inlet cannula obstruction and right ventricular failure |
Specialty: Critical Care, Emergency Medicine, Cardiology
ICD-10: ,
