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Table 5 Hemodynamic assessment of RV function

From: Perioperative Quality Initiative (POQI) consensus statement on perioperative assessment of right ventricular function

Variable

Calculation

Thresholds associated with clinical events in specific populations

RAP

RAP (or CVP)

 > 15 mm Hg (RHF after LVAD)

Right-to-left discordance of filling pressures

RAP:PCWP

 > 0.63 (RHF after LVAD); > 0.86 (RHF in acute MI)

PA pulsatility index

(PASP − PADP)/RAP

 < 1.0 (RHF in acute MI); < 1.85 (RHF after LVAD)

RV stroke work index

(MPAP − CVP) × SVI

 < 0.25–0.30 mm Hg·L/m2 (RHF after LVAD)

PVR

(MPAP − PCWP)/CO

 > 3.6 WU (RHF after LVAD)

PA compliance

SV/(PASP − PADP)

 < 2.5 mL/mm Hg (RHF in chronic HF, RV-PA coupling in PAH)

CO

Thermodilution

CO < 4.2L/min

CI

Fick’s calculation

CI < 2.4 L/min/m2

  1. CO Cardiac output, CI Cardiac index, CVP Central venous pressure, LVAD Left ventricular assist device, MI Myocardial infarction, MPAP Mean pulmonary artery pressure, PA Pulmonary artery, PADP Pulmonary artery diastolic pressure, PAH Pulmonary artery hypertension, PASP Pulmonary artery systolic pressure, PCWP Pulmonary capillary wedge pressure, PVR Pulmonary vascular resistance, RAP Right atrial pressure, RH Right heart, RHF Right heart failure, RV Right ventricular, SV Stroke volume, SVI Stroke volume index (SVI = stroke volume/BSA), WUWoods units. Adapted with permission from Kapur et al. (Otani et al. 2020) Copyright © 2017, American Heart Association
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Perioperative Medicine

ISSN: 2047-0525