Pulmonary artery catheterization allows for continuous monitoring of hemodynamic parameters, which can help with perioperative management in heart surgery patients. On the other hand, primary data suggest that pulmonary artery catheterization is ineffective in acute care and surgical settings. For a study, researchers examined the effects of pulmonary artery catheter insertion against routine central venous pressure monitoring on short-term postoperative outcomes in a large, contemporary cohort of patients undergoing open-heart surgery. From 2010 to 2018, this was an observational study of open-heart surgery. Patients with pulmonary artery catheter placement were identified and matched 1:1 closest neighbor propensity matching patients without pulmonary artery catheter insertion. The influence of pulmonary artery catheterization open relative mortality in the total population and recent heart failure, mitral valve disease, and tricuspid insufficiency subgroups was assessed using multivariable analysis.
About 4,605 (39.0%) of the 11,820 patients who underwent (Society of Thoracic Surgeons indexed) coronary or valvular surgery had a pulmonary artery catheter inserted. Researchers found 3,519 evenly balanced couples using propensity score matching. In the general cohort and the recent heart failure, mitral valve disease, and tricuspid insufficiency subgroups, pulmonary artery catheter use was not linked with lower surgical mortality than central venous pressure monitoring. The length of stay in the intensive care unit was longer (P<.001), and the pulmonary artery catheterization group received more packed red blood cell transfusions (P<.001); however, postoperative outcomes were otherwise similar, including stroke, sepsis, and new renal failure (P>.05). These data show that pulmonary artery catheterization in cardiac surgery may be of limited benefit.
Reference:www.jtcvs.org/article/S0022-5223(21)00185-9/fulltext
