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Pulmonary artery catheter use and in-hospital outcomes in cardiac surgery: a systematic review and meta-analysis.


ABSTRACT:

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 = 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) = 0.20; 95% CI 0.16-0.23], longer intensive care unit stay (SMD = 0.29; 95% CI 0.25-0.33), and longer intubation time (SMD = 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.

SUBMITTER: Rong LQ 

PROVIDER: S-EPMC11254303 | biostudies-literature | 2024 Jul

REPOSITORIES: biostudies-literature

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Publications

Pulmonary artery catheter use and in-hospital outcomes in cardiac surgery: a systematic review and meta-analysis.

Rong Lisa Q LQ   Luhmann Grant G   Di Franco Antonino A   Dimagli Arnaldo A   Perry Luke A LA   Martinez Andrew P AP   Demetres Michelle M   Mazer C David CD   Bellomo Rinaldo R   Gaudino Mario M  

Interdisciplinary cardiovascular and thoracic surgery 20240701 1


<h4>Objectives</h4>To determine the association of intraoperative pulmonary artery catheter (PAC) use with in-hospital outcomes in cardiac surgical patients.<h4>Methods</h4>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, intubatio  ...[more]

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