TY - JOUR
T1 - Pulmonary artery catheter use and in-hospital outcomes in cardiac surgery
T2 - a systematic review and meta-analysis
AU - Rong, Lisa Q.
AU - Luhmann, Grant
AU - Franco, Antonino Di
AU - Dimagli, Arnaldo
AU - Perry, Luke A.
AU - Martinez, Andrew P.
AU - Demetres, Michelle
AU - Mazer, C. David
AU - Bellomo, Rinaldo
AU - Gaudino, Mario
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/7
Y1 - 2024/7
N2 - OBJECTIVES: To determine the association of intraoperative pulmonary artery catheter (PAC) use with in-hospital outcomes in cardiac surgical patients. METHODS: MEDLINE, Embase, and Cochrane Library (Wiley) databases were screened for studies that compared cardiac surgical patients receiving intraoperative PAC with controls and reporting in-hospital mortality. Secondary outcomes included intensive care unit length of stay, cost of hospitalization, fluid volume administered, intubation time, inotropes use, acute kidney injury (AKI), stroke, myocardial infarction (MI), and infections. RESULTS: Seven studies (25 853 patients, 88.6% undergoing coronary artery bypass graft surgery) were included. In-hospital mortality was significantly increased with PAC use [odds ratio (OR) 1.57; 95% confidence interval (CI) 1.12–2.20, P ¼ 0.04]; PAC use was also associated with greater intraoperative inotrope use (OR 2.61; 95% CI 1.54–4.41) and costs [standardized mean difference (SMD) ¼ 0.20; 95% CI 0.16–0.23], longer intensive care unit stay (SMD ¼ 0.29; 95% CI 0.25–0.33), and longer intubation time (SMD ¼ 0.44; 95% CI 0.12–0.76). CONCLUSIONS: PAC use is associated with significantly increased odds of in-hospital mortality, but the amount and quality of the available evidence is limited. Prospective randomized trials testing the effect of PAC on the outcomes of cardiac surgical patients are urgently needed.
AB - OBJECTIVES: To determine the association of intraoperative pulmonary artery catheter (PAC) use with in-hospital outcomes in cardiac surgical patients. METHODS: MEDLINE, Embase, and Cochrane Library (Wiley) databases were screened for studies that compared cardiac surgical patients receiving intraoperative PAC with controls and reporting in-hospital mortality. Secondary outcomes included intensive care unit length of stay, cost of hospitalization, fluid volume administered, intubation time, inotropes use, acute kidney injury (AKI), stroke, myocardial infarction (MI), and infections. RESULTS: Seven studies (25 853 patients, 88.6% undergoing coronary artery bypass graft surgery) were included. In-hospital mortality was significantly increased with PAC use [odds ratio (OR) 1.57; 95% confidence interval (CI) 1.12–2.20, P ¼ 0.04]; PAC use was also associated with greater intraoperative inotrope use (OR 2.61; 95% CI 1.54–4.41) and costs [standardized mean difference (SMD) ¼ 0.20; 95% CI 0.16–0.23], longer intensive care unit stay (SMD ¼ 0.29; 95% CI 0.25–0.33), and longer intubation time (SMD ¼ 0.44; 95% CI 0.12–0.76). CONCLUSIONS: PAC use is associated with significantly increased odds of in-hospital mortality, but the amount and quality of the available evidence is limited. Prospective randomized trials testing the effect of PAC on the outcomes of cardiac surgical patients are urgently needed.
KW - Cardiac surgery
KW - Meta-analysis
KW - Mortality
KW - Perioperative outcomes
KW - Pulmonary artery catheter
UR - https://www.scopus.com/pages/publications/85199247622
U2 - 10.1093/icvts/ivae129
DO - 10.1093/icvts/ivae129
M3 - Review Article
C2 - 38976638
AN - SCOPUS:85199247622
SN - 2753-670X
VL - 39
JO - Interdisciplinary Cardiovascular and Thoracic Surgery
JF - Interdisciplinary Cardiovascular and Thoracic Surgery
IS - 1
M1 - ivae129
ER -