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

TitlePulmonary artery catheter use and in-hospital outcomes in cardiac surgery: a systematic review and meta-analysis.
Publication TypeJournal Article
Year of Publication2024
AuthorsRong LQ, Luhmann G, Di Franco A, Dimagli A, Perry LA, Martinez AP, Demetres M, C Mazer D, Bellomo R, Gaudino M
JournalInterdiscip Cardiovasc Thorac Surg
Volume39
Issue1
Date Published2024 Jul 03
ISSN2753-670X
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.

DOI10.1093/icvts/ivae129
Alternate JournalInterdiscip Cardiovasc Thorac Surg
PubMed ID38976638
PubMed Central IDPMC11254303
Grant ListK23 HL153836 / HL / NHLBI NIH HHS / United States
K23 HL153836 / NH / NIH HHS / United States