Meta-Analysis of Use of Pulmonary Artery Catheter and Mortality in Patients With Cardiogenic Shock on Mechanical Circulatory Support

There is controversy around the use of the pulmonary artery catheter (PAC) in guiding the management of cardiogenic shock (CS) based on the ESCAPE trial (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) and other studies, which showed there was no bene...

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Bibliographic Details
Published in:The American journal of cardiology 2022-10, Vol.180, p.165-166
Main Authors: Radaideh, Qais, Abusnina, Waiel, Ponamgi, Shiva, Al-Abdouh, Ahmad, Aboeata, Ahmed, Kanmanthareddy, Arun, Alqarqaz, Mohammad, Dahal, Khagendra
Format: Article
Language:English
Subjects:
Catheters
Confidence intervals
Congestive heart failure
Heart failure
Hemodynamics
Medical instruments
Meta-analysis
Monitoring
Mortality
Population studies
Pulmonary arteries
Pulmonary artery
Veins & arteries
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Summary:There is controversy around the use of the pulmonary artery catheter (PAC) in guiding the management of cardiogenic shock (CS) based on the ESCAPE trial (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) and other studies, which showed there was no benefit from PAC monitoring. The use of PAC has decreased over the years, although those studies did not enroll patients with CS.1–3 More notable is that PAC use has not been studied as part of a randomized, controlled trial in patients with CS with or without mechanical circulatory support (MCS).4 Existing data obtained from the study population without CS have revealed contradictory results.5 Recently, there has been an increased focus on the use of PAC among this category of patients, especially those placed on MCS. [...]in this meta-analysis, we found that the lack of hemodynamic monitoring through PAC in patients with CS was associated with increased mortality.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2022.06.027