Associations Between Pulmonary Artery Catheter Use and Outcomes After Cardiac Surgery: An Entropy-Balanced Cohort...

Area of Science:

• Cardiovascular Surgery
• Critical Care Medicine
• Medical Device Outcomes Research

Background:

• Pulmonary artery catheters (PACs) are frequently used in cardiac surgery.
• Existing research shows conflicting associations between PAC use and patient outcomes.
• This study investigates the relationship between PAC use and clinical outcomes in a large cardiac surgery cohort.

Purpose of the Study:

• To evaluate the association between pulmonary artery catheter use and clinical outcomes following cardiac surgery.
• To assess the impact of PACs on mortality, acute kidney injury, length of stay, and organ dysfunction.

Main Methods:

• Retrospective, entropy-balanced cohort study of 10,044 adult cardiac surgery patients (2008-2022).
• Entropy balancing was used to ensure covariate balance on baseline characteristics.
• Primary outcome: 90-day mortality. Secondary outcomes included AKI, LOS, organ dysfunction, and treatment intensity metrics.

Main Results:

• PAC use was not associated with 90-day or in-hospital mortality.
• PAC use was linked to significantly longer ICU length of stay (13.1 hours greater).
• PAC use correlated with increased acute kidney injury, prolonged inotrope/vasopressor use, higher fluid balance, greater RBC transfusion, and longer mechanical ventilation duration.

Conclusions:

• In adult cardiac surgery, PAC use is not associated with mortality.
• PAC use is associated with increased treatment intensity and longer ICU stays.
• Findings suggest a need for careful evaluation of PAC necessity and potential impact on resource utilization and patient recovery.