Association of heartmate ii left ventricular assist device flow estimate with thermodilution cardiac output

Tal Hasin, Marianne Huebner, Zhuo Li, Daniel Brown, John M. Stulak, Barry A. Boilson, Lyle Joyce, Naveen L. Pereira, Sudhir S. Kushwaha, Soon J Park

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Cardiac output (CO) assessment is important in treating patients with heart failure. Durable left ventricular assist devices (LVADs) provide essentially all CO. In currently used LVADs, estimated device flow is generated by a computerized algorithm. However, LVAD flow estimate may be inaccurate in tracking true CO. We correlated LVAD (HeartMate II) flow with thermodilution CO during postoperative care (day 2-10 after implant) in 81 patients (5,616 paired measurements). Left ventricular assist device flow and CO correlated with a low correlation coefficient (r = 0.42). Left ventricular assist device readings were lower than CO measurements by approximately 0.36 L/min, trending for larger difference with higher values. Left ventricular assist device flow measurements showed less temporal variability compared with CO. Grouping for simultaneous measured blood pressure (BP < 60, 60-70, 70-80, 80-90, and ≥ 90), the correlation of CO with LVAD flow differed (R = 0.42, 0.67, 0.48, 0.32, 0.32, respectively). Indicating better correlation when mean blood pressure is 60 to 70 mm Hg. Left ventricular assist device flow generally trends with measured CO, but large variability exists, hence flow measures should not be assumed to equal with CO. Clinicians should take into account variables such as high CO, BP, and opening of the aortic valve when interpreting LVAD flow readout. Direct flow sensors incorporated in the LVAD system may allow for better estimation.

Original languageEnglish (US)
Pages (from-to)513-518
Number of pages6
JournalASAIO Journal
Volume60
Issue number5
DOIs
StatePublished - Jan 1 2014

Keywords

  • Blood pressure
  • Cardiac output
  • Flow
  • Heart assist device

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

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    Hasin, T., Huebner, M., Li, Z., Brown, D., Stulak, J. M., Boilson, B. A., Joyce, L., Pereira, N. L., Kushwaha, S. S., & Park, S. J. (2014). Association of heartmate ii left ventricular assist device flow estimate with thermodilution cardiac output. ASAIO Journal, 60(5), 513-518. https://doi.org/10.1097/MAT.0000000000000119