Current use of the pulmonary artery catheter in cardiac surgery

A survey study

Onkar Judge, Fuhai Ji, Neal Fleming, Hong Liu

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective Because of its invasive nature, debated effect on patient outcome, and the development of alternative hemodynamic monitoring technologies, the intraoperative use of the pulmonary artery catheter (PAC) has significantly decreased. The authors conducted a survey of the members of the Society of Cardiovascular Anesthesiologists (SCA) to assess current use of the PAC and alternative hemodynamic monitoring technologies in patients undergoing cardiac surgery. Design A survey study. Setting Hospitals in North America, Europe, Asia, Australia, New Zealand, and South America. Participants SCA members in North America, Europe, Asia, Australia, New Zealand, and South America. Interventions The survey was e-mailed by the SCA to roughly 6,000 of its members. Measurements and Main Results The survey was left open for 30 days. Respondents accessed the survey via a secured web-based database. A total of 854 questionnaires were completed. A total of 705 (82.6%) were from North American members. Four hundred twelve of the respondents (48.1%) worked in a private practice setting, while 350 (40.9%) were from an academic practice. A majority of the respondents (57.9%) were from hospitals that performed more than 400 cardiac surgeries a year, a subset of which (29.6%) did more than 800 cases annually. For cases using cardiopulmonary bypass, 583 (68.2%) of the respondents used a PAC more than 75% of the time, while 30 (3.5%) did not use the PAC at all. Ninety-four percent of respondents used transesophageal echocardiography (TEE) as part of the intraoperative monitoring. When not using a PAC, FloTrac/Vigileo was the alternative cardiac monitoring modality in 15.2% of the responses. Similar trends in monitor preferences were seen in off-pump coronary artery bypass grafting and minimally invasive/robotic heart surgery. Conclusions The results of this study suggested that a majority of the respondents still prefer to use the PAC for most cardiac surgeries. Subgroup analysis of the data revealed that geographical location, type of practice, and surgeon support played a significant role in the decision to use a PAC. Although most respondents prefer to use TEE as a complimentary tool, TEE also remains the most popular supplemental/alternative hemodynamic monitoring technology.

Original languageEnglish (US)
Pages (from-to)69-75
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume29
Issue number1
DOIs
StatePublished - Feb 1 2015

Fingerprint

Pulmonary Artery
Thoracic Surgery
Catheters
Transesophageal Echocardiography
Intraoperative Monitoring
South America
Hemodynamics
North America
Technology
New Zealand
Surveys and Questionnaires
Off-Pump Coronary Artery Bypass
Private Practice
Robotics
Cardiopulmonary Bypass
Coronary Artery Bypass
Databases

Keywords

  • cardiac surgery
  • hemodynamic monitoring
  • pulmonary artery catheter

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

Cite this

Current use of the pulmonary artery catheter in cardiac surgery : A survey study. / Judge, Onkar; Ji, Fuhai; Fleming, Neal; Liu, Hong.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 29, No. 1, 01.02.2015, p. 69-75.

Research output: Contribution to journalArticle

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abstract = "Objective Because of its invasive nature, debated effect on patient outcome, and the development of alternative hemodynamic monitoring technologies, the intraoperative use of the pulmonary artery catheter (PAC) has significantly decreased. The authors conducted a survey of the members of the Society of Cardiovascular Anesthesiologists (SCA) to assess current use of the PAC and alternative hemodynamic monitoring technologies in patients undergoing cardiac surgery. Design A survey study. Setting Hospitals in North America, Europe, Asia, Australia, New Zealand, and South America. Participants SCA members in North America, Europe, Asia, Australia, New Zealand, and South America. Interventions The survey was e-mailed by the SCA to roughly 6,000 of its members. Measurements and Main Results The survey was left open for 30 days. Respondents accessed the survey via a secured web-based database. A total of 854 questionnaires were completed. A total of 705 (82.6{\%}) were from North American members. Four hundred twelve of the respondents (48.1{\%}) worked in a private practice setting, while 350 (40.9{\%}) were from an academic practice. A majority of the respondents (57.9{\%}) were from hospitals that performed more than 400 cardiac surgeries a year, a subset of which (29.6{\%}) did more than 800 cases annually. For cases using cardiopulmonary bypass, 583 (68.2{\%}) of the respondents used a PAC more than 75{\%} of the time, while 30 (3.5{\%}) did not use the PAC at all. Ninety-four percent of respondents used transesophageal echocardiography (TEE) as part of the intraoperative monitoring. When not using a PAC, FloTrac/Vigileo was the alternative cardiac monitoring modality in 15.2{\%} of the responses. Similar trends in monitor preferences were seen in off-pump coronary artery bypass grafting and minimally invasive/robotic heart surgery. Conclusions The results of this study suggested that a majority of the respondents still prefer to use the PAC for most cardiac surgeries. Subgroup analysis of the data revealed that geographical location, type of practice, and surgeon support played a significant role in the decision to use a PAC. Although most respondents prefer to use TEE as a complimentary tool, TEE also remains the most popular supplemental/alternative hemodynamic monitoring technology.",
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N2 - Objective Because of its invasive nature, debated effect on patient outcome, and the development of alternative hemodynamic monitoring technologies, the intraoperative use of the pulmonary artery catheter (PAC) has significantly decreased. The authors conducted a survey of the members of the Society of Cardiovascular Anesthesiologists (SCA) to assess current use of the PAC and alternative hemodynamic monitoring technologies in patients undergoing cardiac surgery. Design A survey study. Setting Hospitals in North America, Europe, Asia, Australia, New Zealand, and South America. Participants SCA members in North America, Europe, Asia, Australia, New Zealand, and South America. Interventions The survey was e-mailed by the SCA to roughly 6,000 of its members. Measurements and Main Results The survey was left open for 30 days. Respondents accessed the survey via a secured web-based database. A total of 854 questionnaires were completed. A total of 705 (82.6%) were from North American members. Four hundred twelve of the respondents (48.1%) worked in a private practice setting, while 350 (40.9%) were from an academic practice. A majority of the respondents (57.9%) were from hospitals that performed more than 400 cardiac surgeries a year, a subset of which (29.6%) did more than 800 cases annually. For cases using cardiopulmonary bypass, 583 (68.2%) of the respondents used a PAC more than 75% of the time, while 30 (3.5%) did not use the PAC at all. Ninety-four percent of respondents used transesophageal echocardiography (TEE) as part of the intraoperative monitoring. When not using a PAC, FloTrac/Vigileo was the alternative cardiac monitoring modality in 15.2% of the responses. Similar trends in monitor preferences were seen in off-pump coronary artery bypass grafting and minimally invasive/robotic heart surgery. Conclusions The results of this study suggested that a majority of the respondents still prefer to use the PAC for most cardiac surgeries. Subgroup analysis of the data revealed that geographical location, type of practice, and surgeon support played a significant role in the decision to use a PAC. Although most respondents prefer to use TEE as a complimentary tool, TEE also remains the most popular supplemental/alternative hemodynamic monitoring technology.

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