Photo Credit: Mr. Suphachai Praserdumrongchai

The following is a summary of “Association of the pulmonary artery pulsatility index and right ventricular function after cardiac surgery,” published in February 2024, issue of Critical Care by Wei et al.

The Pulmonary Artery Pulsatility Index (PAPi), derived from the pulse pressures of the right atrium and pulmonary artery, has demonstrated a correlation with right ventricular (RV) failure in individuals with cardiac conditions.

Researchers conducted a retrospective study to investigate the association between postoperative PAPi and RV function following cardiac surgery and assess the impact of PAPi on postoperative outcomes. 

They obtained data from the electronic medical record system for 959 adult patients undergoing cardiac surgery. They evaluated the association of post-bypass RV function and other clinical factors with PAPi using linear regression. Additionally, they employed a propensity-score matched group with PAPi ≥ 2.00 to evaluate the relationship between PAPi and postoperative outcomes.

The results showed that out of 959 patients, 156 (16.3%) had post-bypass RV dysfunction—no significant difference in postoperative PAPi based on RV function (2.12 vs. 2.00, P=0.21). Within the matched cohort (n = 636), a PAPi < 2.00 demonstrated a higher occurrence of acute kidney injury (23.0% vs. 13.2%, P<0.01) and extended ventilator time (6.0 hours vs. 5.6 hours, P=0.04). However, no correlation was observed with length of stay in the ICU. 

Investigators concluded that while postoperative PAPi did not show a significant association with post-cardiopulmonary bypass RV dysfunction in a general cohort of patients undergoing cardiac surgery, a postoperative PAPi < 2 may be linked to an increased risk of acute kidney injury.

Source: hindawi.com/journals/ccrp/2024/5408008/