著者

Aki Kuwauchi Satomi Yoshida Shiro Tanaka Sachiko Tanaka Chikashi Takeda Hiroshi Yonekura Isao Nahara Koji Kawakami

出版者

Society for Clinical Epidemiology

雑誌

Annals of Clinical Epidemiology (ISSN:24344338)

巻号頁・発行日

pp.22011, (Released:2022-03-11)

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BackgroundThe controversy concerning the benefits of pulmonary artery catheter (PAC)-based hemodynamic monitoring in cardiac surgeries has not been adequately addressed. This study aims to compare the all-cause mortality between the PAC with venous oxygen saturation monitoring and the Vigileo/FloTrac (FloTrac) system with central venous oxygen saturation monitoring in cardiac surgeries.MethodsThis nationwide retrospective study includes adult patients who underwent elective cardiac surgeries between April 2010 and October 2014, based on the Japanese health insurance claims database. The main outcome was 30-day all-cause mortality. Propensity scores (PS) were used to adjust for the confounding factors. Treatment effects were estimated using multivariable logistic regression analysis, including PS.ResultsA total of 5,838 patients were included in this study. The crude 30-day mortality rates were 2.4% (8/334) and 1.7% (96/5,504) in the FloTrac and PAC groups, respectively. After PS matching, the ORs for 30-day all-cause mortality, in-hospital mortality after PAC placement (vs. FloTrac) were 0.36 (95% CI: 0.05 – 2.37; p= 0.28) and 0.59 (95% CI: 0.16 – 2.20; p= 0.43), respectively. The amount of dobutamine was larger in the PAC group (281±31 mg vs 155±19 mg; p <0.001). There were no significant differences in the amounts of other inotropes, the volume of fluids, or blood transfusions.ConclusionsThe association between PAC (with venous oxygen saturation monitoring) and mortality in patients who underwent elective cardiac surgeries was unclear compared to FloTrac (with central venous oxygen saturation monitoring). Additional investigation is needed to evaluate the benefits of PAC-specific hemodynamic parameters in this population.