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[Pulmonary artery catheterization in the intensive care unit: at what time?]
J Y Lefrant1, J Ripart, J E de La Coussaye
1Fédération d'anesthésie-douleur-urgence-réanimation, CHU Nîmes, 5, rue Hoche, 30029 Nîmes, France. jean.yves.lefrant@chu-nimes.fr
Objectives:
Recording the time at which the insertion of a pulmonary artery catheter was decided.
Study Design:
Prospective and descriptive study.
Patients:
Critically ill patients in an university hospital.
Methods:
The times at which the insertion of a PAC was decided were recorded. For each pulmonary artery catheterization, immediate complications were recorded (arterial puncture, pneumothorax, ventricular arrhythmia, hard and failed pulmonary artery catheterization).
Results:
One hundred and forty-nine patients were included (99 males, age = 63 +/- 15 year, body mass index = 25 +/- 6 kg.m-2, median Apache II score = 16). One hundred and sixty-five PAC insertions were decided (16 patients requiring two PACs). Nine arterial punctures, two pneumothoraces, 42 ventricular arrhythmias, 32 hard and eight failed pulmonary artery catheterizations occurred. Thirty-four PAC insertions were decided between 9 and 10 am whereas = 3 PAC insertions per hour were decided between 1 and 9 am.
Conclusion:
The rate of decision of PAC insertion are decreased during the second half of the night (1 to 9 AM).