Hemodynamic resuscitation with a Swan-Ganz catheter in cardiogenic shock.

The Role of Swan-Ganz Catheter in Hemodynamic Resuscitation for Patients With Cardiogenic Shock

This will try using a Swan‑Ganz (pulmonary artery) catheter to guide medicines and fluids in adults who have cardiogenic shock after a heart attack.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 108 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Bach Mai Hospital (Academic / other)
• Locations: 1 site (Hanoi)
• Trial ID: NCT07062744 on ClinicalTrials.gov

What this trial studies

This single-center, non-randomized interventional protocol enrolls adults with cardiogenic shock secondary to acute myocardial infarction and uses a Swan‑Ganz pulmonary artery catheter to guide goal-directed hemodynamic optimization. The catheter provides continuous pressures, thermodilution cardiac output, and mixed venous oxygen saturation, recorded at baseline and predefined early intervals (0, 3, 6, 9, 12, 24 hours) to steer therapy. Treatments are titrated to predefined hemodynamic targets—cardiac index ≥2.2 L/min/m², mean arterial pressure ≥65 mmHg, PCWP 12–18 mmHg, CVP 8–12 mmHg, SvO₂ >60–80%, and lactate <2 mmol/L—through adjustments in inotropes, vasopressors, and fluids. The primary endpoint is 30‑day all‑cause mortality with in-hospital mortality and duration of vasoactive support among the secondary outcomes.

Who should consider this trial

Good fit: Ideal candidates are adults with cardiogenic shock caused by acute myocardial infarction (sustained systolic BP <90 mmHg or needing vasopressors plus signs of end‑organ hypoperfusion) who can provide informed consent.

Not a fit: Patients with contraindications to central catheter placement (active cervical infection, prior neck radiation, coagulopathy), with end‑stage comorbidities, or who have had cardiac arrest or mechanical complications are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, Swan‑Ganz guided resuscitation could lower 30‑day mortality and help personalize hemodynamic support in AMI‑related cardiogenic shock.

How similar studies have performed: Randomized trials of routine pulmonary artery catheter use in broader critical care populations did not show clear outcome benefit, but observational and registry data in cardiogenic shock suggest targeted hemodynamic guidance may help, and randomized evidence in AMI‑related cardiogenic shock remains limited.

Eligibility criteria

Inclusion Criteria:

* Age ≥ 18 years.
* Provided written informed consent to participate in the study.
* Diagnosed with cardiogenic shock due to acute myocardial infarction according to IABP-SHOCK II (2012) criteria:

  * Systolic blood pressure (SBP) \< 90 mmHg for at least 30 minutes, or requiring vasopressor agents to maintain SBP \> 90 mmHg.
  * Evidence of end-organ hypoperfusion, indicated by at least one of the following: Altered mental status, Urine output \< 30 mL/hour, Cold extremities with mottled skin, Serum lactate level \> 2 mmol/L.

Exclusion Criteria:

* Presence of cervical cellulitis.
* Inability to identify neck anatomy or history of cervical radiotherapy.
* Coagulopathy (INR \> 1.5 and/or platelet count \< 50 G/L).
* End-stage chronic diseases, including: Advanced malignancy, advanced-stage HIV, bedridden patients for more than 3 months, decompensated liver cirrhosis (Child-Pugh class C).
* Patients with cardiac arrest or mechanical complications such as myocardial rupture prior to Swan-Ganz catheterization.
* Congenital heart defects or intracardiac shunts. Refusal of participation by the patient or their legal representative.

Where this trial is running

Hanoi

• BachMai Hospital, Hanoi Medical University — Hanoi, Vietnam (Recruiting)

Study contacts

• Principal investigator: Thang Xuan Pham, MD, PhD Candidate — Hanoi Medical University
• Study coordinator: Thang Xuan Pham, MD, PhD Candidate

Conditions Cardiogenic Shock; Pulmonary Artery Catheter Waveform Interpretation; Hemodynamic Management; Hemodynamic Optimization; Hemodynamic Monitoring; Acute Myocardial Infarction; Critical Care, Intensive Care; Emergency