Continuous Non-Invasive Haemodynamic Monitoring During Primary Percutaneous Coronary Intervention

Background/Objectives: Haemodynamic assessment during primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is mostly restricted to continuous monitoring of arterial blood pressure. The volume-clamp method provides continuous non-invasive arterial pressure monitoring without the need for vascular access, together with simultaneous estimation of stroke volume, cardiac output and other haemodynamic variables, but its feasibility during primary PCI has not been evaluated.

Methods

In this prospective observational study, 33 patients with STEMI undergoing primary PCI were monitored continuously (Acumen IQ, HemoSphere) at seven pre-specified timepoints: baseline, guidewire crossing of the culprit lesion, stent implantation, end of procedure, and after 1, 6 and 24 h. Patients with cardiogenic shock, ongoing cardiopulmonary resuscitation or symptom onset more than 24 h before admission were excluded. Cardiac index (CI), stroke volume index (SVI), systemic vascular resistance index (SVRI), pulse rate, dP/dt, mean arterial pressure (MAP) and the Hypotension Prediction Index (HPI) were analysed using linear mixed models with Holm correction within families of related tests.