The efficacy of pulmonary artery catheters in reducing mortality in acute heart failure cardiogenic shock: A systematic review
•Cardiogenic shock (CS) poses a significant threat, affecting over 50 % of acutely decompensated heart failure (ADHF) patients, with mortality rates ranging from 40 % to 59 %.•Limited focus on invasive hemodynamic monitoring with pulmonary artery catheters (PACs) in CS prompts a systematic review to...
Saved in:
| Published in: | Heart & lung Vol. 66; pp. 123 - 128 |
|---|---|
| Main Author: | |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Elsevier Inc
01-06-2024
|
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | •Cardiogenic shock (CS) poses a significant threat, affecting over 50 % of acutely decompensated heart failure (ADHF) patients, with mortality rates ranging from 40 % to 59 %.•Limited focus on invasive hemodynamic monitoring with pulmonary artery catheters (PACs) in CS prompts a systematic review to address this gap.•Patients with a PAC show lower 30-day in-hospital mortality rates at 22.2 %−55 % compared to patients without a PAC, 29.8 %−78 %.•The controversial appropriateness of PACs since the 1970s necessitates personalized approaches, emphasizing the crucial role of large-scale randomized studies with standardized protocols for conclusive evidence and advancements in care.
Cardiogenic shock (CS), a complex and life-threatening medical condition, has an astounding hospital mortality rate spanning from 40 % to 59 %. Frequently, CS requires the use of pulmonary artery catheters (PACs) for management.
This literature review aims to investigate the relationship between PAC utilization in CS patients and in-hospital 30-day mortality rates compared to noninvasive vital sign monitoring alone.
An integrative literature search was conducted from January 1, 2003, until August 1, 2023. The review focused on patients with acute decompensated heart failure CS. It compared PAC and non-PAC hemodynamic monitoring with 30-day mortality outcomes. Five articles met the inclusion criteria and underwent quality assessment using CONSORT, STROBE, and STARD guidelines.
Five articles totaled 332,794 patients. Patients with a PAC showed lower 30-day in-hospital mortality rates (22.2 % to 55 %) than patients without a PAC (29.8–78 %). One study, however, indicated that PAC use did not significantly affect mortality rates (p = 0.66). Notably, the lowest mortality rates (25 %) were linked to complete hemodynamic profiling with a PAC.
The mortality rates showed greater significance when PAC initiation occurred early, resulting in a further reduction of the mortality rate to 17.3 %. Conversely, mortality rates increased to 27.7 % with delayed PAC initiation, 40 % with incomplete hemodynamic profiling, and 35 % with no PAC use.
PAC utilization reduces in-hospital mortality for the CS patient population, as suggested by the analyzed studies. Further research via randomized controlled trials (RCTs) with standardized treatment protocols and adequate follow-up are required to validate the findings. |
|---|---|
| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
| ISSN: | 0147-9563 1527-3288 1527-3288 |
| DOI: | 10.1016/j.hrtlng.2024.02.012 |