Questionable benefit of the pulmonary artery catheter after cardiac surgery in high-risk patients

Chiang, Yuting; Hosseinian, Leila; Rhee, Amanda; Itagaki, Shinobu; Cavallaro, Paul; Chikwe, Joanna

doi:10.1053/j.jvca.2014.07.017

Cited by 71Hemodynamic Monitoring and TherapyCardiac, Anesthesia and Surgical OutcomesCardiac and Coronary Surgery Techniques

Questionable benefit of the pulmonary artery catheter after cardiac surgery in high-risk patients

Chiang, Yuting, Hosseinian, Leila, Rhee, Amanda, Itagaki, Shinobu, Cavallaro, Paul, Chikwe, Joanna·2015·Journal of Cardiothoracic and Vascular Anesthesia

DOI 10.1053/j.jvca.2014.07.017

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Abstract

Objective The aim of this study was to determine the effect of pulmonary artery catheterization on clinical outcomes after cardiac surgery in higher-risk patients.Design Retrospective national database analysis.Setting U.S. hospitals.Participants A weighted sample of 2,063,337 patients undergoing cardiac surgery identified from the Nationwide Inpatient Sample (NIS) from January 1, 2000 to December 31, 2010.Interventions Pulmonary artery catheterization.Measurements and main results Compared to patients who did not receive a pulmonary artery catheter, those who did on the whole were on average slightly older (66.6±11.9 years v 65.5±12.8 years, p<0.001), more likely to have pulmonary hypertension (7.5% v 5.1%, p<0.001), chronic obstructive pulmonary disease (24.6% v 20.7%, p<0.001), obesity (15.0% v 13.1%, p<0.001), and chronic renal failure (10.9% v 9.2%, p<0.001). In multivariate analysis, the risk of operative mortality in patients who underwent pulmonary artery catheterization was significantly higher than in those who did not (4.6% v 3.1%, p<0.001), adjusted OR 1.34 (95% CI 1.26-1.43, p<0.001). In propensity matched subgroup analysis operative mortality risk was higher in octogenarian patients (OR 1.24, p = 0.24), and patients with congestive heart failure (OR 1.39, p = 0.023) who underwent pulmonary artery catheterization. No significant difference in operative mortality was observed in low-risk patients according to whether or not they underwent pulmonary artery catheterization. The incidence of prolonged mechanical ventilation and length of stay>30 days was higher in patients who underwent pulmonary artery catheterization in all subgroups.Conclusions In contemporary practice pulmonary artery catheters do not appear to be associated with reductions in operative mortality or morbidity and are associated with increases in duration of ventilation and length of stay in the intensive care unit.

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From Definitions of low cardiac output syndrome after cardiac surgery and their effect on the incidence of intraoperative LCOS: A literature review and cohort study (2022) · cites this paper as [93]

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Ertugay, S., Kahraman, Ü., Oğuz, E., Demir, E., Öztürk, E., Kocabaş, S., Tuncer, O. N., Öztürk, P., & Özbaran, M. (2024) · Medicine · doi:10.1097/md.0000000000040884
第19号肺動脈カテーテルに係る死亡事例の分析
福井, 重., & 井澤, 英. (2024) · Nihon Naika Gakkai Zasshi · doi:10.2169/naika.113.1014
Anesthetic Perspective on Total Arch Replacement With Frozen Elephant Trunk Surgery
Jang, M.-S., Nam, S. B., Kim, Y. J., Woo, J. H., & Song, S. (2025) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2025.11.007
Additional file 12 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337490
Additional file 11 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337487
Additional file 14 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337496
Additional file 13 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337493
Additional file 2 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337502
Additional file 5 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337511
Additional file 7 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337517
Additional file 3 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337505
Additional file 1 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337499
Additional file 10 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337484
Additional file 6 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337514
Additional file 1 of Characteristics of pulmonary artery catheter use in multicenter ICUs in Japan and the association with mortality: a multicenter cohort study using the Japanese Intensive care PAtient Database
Fukano, K., Iizuka, Y., Nishiyama, S., Yoshinaga, K., Uchino, S., Sasabuchi, Y., & Sanui, M. (2023) · Figshare · doi:10.6084/m9.figshare.24454984
Additional file 9 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337523
Additional file 4 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337508
Additional file 8 of Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Kouz, K., Michard, F., Bergholz, A., Vokuhl, C., Briesenick, L., Hoppe, P., Flick, M., Schön, G., & Saugel, B. (2021) · Figshare · doi:10.6084/m9.figshare.14337520

The impact of pulmonary artery catheter use in cardiac surgery
Brown, J. A., Aranda-Michel, E. C., Kilic, A., Serna-Gallegos, D. R., Bianco, V. J., Thoma, F. W., & Sultan, I. S. (2021) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2021.01.086 · Cited by 50 · see citing works
Pulmonary artery catheters are not routinely indicated during and after surgery
Seemungal, T. (2003) · Thorax · doi:10.1136/thorax.58.3.236 · Cited by 1 · see citing works
Associations Between Pulmonary Artery Catheter Use and Outcomes After Cardiac Surgery: An Entropy-Balanced Cohort Study
Perry, L. A., Peiris, S., Greifer, N., Karamesinis, A. D., Rong, L. Q., Gaudino, M. F. L., Smith, J. A., Silvers, A. J., Bennetts, J. S., Segal, R., et al. (2026) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000008198
Pulmonary Artery Catheter Use During Cardiac Surgery in the United States, 2010 to 2014
Brovman, E. Y., Gabriel, R. A., Dutton, R. P., & Urman, R. D. (2015) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2015.11.012 · Cited by 80 · see citing works
Pulmonary-Artery Catheters Not Helpful in High-Risk Surgery Patients
Krumholz, H. M., & Sm (2003) · Journal watch · doi:10.1056/jc200302140000001

Authors: Chiang, Y., Hosseinian, L., Rhee, A., Itagaki, S., Cavallaro, P., & Chikwe, J.
Affiliations: Mount Sinai Hospital (US)
Corresponding author: Chikwe, Joanna
ORCID: Hosseinian, Leila
Rhee, Amanda
Itagaki, Shinobu
Cavallaro, Paul
Chikwe, Joanna
Venue: Journal of Cardiothoracic and Vascular Anesthesia
Publisher: Elsevier BV
Published: 2015-02
Volume: 29
Issue: 1
Pages: 76-81
ISSN: 1053-0770 (ISSN-L)
DOI: 10.1053/j.jvca.2014.07.017
OpenAlex: W2059686141
Cited by: 71
References: 20
Citations by year: 2025: 6 · 2024: 9 · 2023: 4 · 2022: 5 · 2021: 24 · 2020: 6 · 2019: 5 · 2018: 3 · 2017: 2 · 2016: 6 · 2015: 1
FWCI: 4.03
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Cardiothoracic and Vascular Anesthesia (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Keywords: pulmonary artery catheterization, cardiac surgery, high-risk patients, postoperative mortality, mechanical ventilation duration, ICU length of stay, octogenarians, congestive heart failure, pulmonary hypertension, chronic obstructive pulmonary disease, chronic kidney disease, postoperative morbidity
MeSH terms: Aged, Catheterization, Swan-Ganz, Female, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Risk Factors, Cohort Studies, Databases, Factual, Risk Assessment

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Questionable benefit of the pulmonary artery catheter after cardiac surgery in high-risk patients

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