Bethlehem Carina, Groenwold Frouwke M, Buter Hanneke, Kingma W Peter, Kuiper Michael A, de Lange Fellery, Elbers Paul, Groen Henk, van Roon Eric N, Boerma E Christiaan
Department of Intensive Care, Medical Centre Leeuwarden, P.O. Box 888, 8901 BR Leeuwarden, The Netherlands.
Crit Care Res Pract. 2012;2012:161879. doi: 10.1155/2012/161879. Epub 2012 Feb 21.
Objective. The pulmonary artery catheter (PAC) remains topic of debate. Despite abundant data, it is of note that many trials did not incorporate a treatment protocol. Methods. We retrospectively evaluated fluid balances and catecholamine doses in septic patients after the introduction of a PAC-based treatment protocol in comparison to historic controls. Results. 2 × 70 patients were included. The first day the PAC group had a significantly higher positive fluid balance in comparison to controls (6.1 ± 2.6 versus 3.8 ± 2.4 litre, P < 0.001). After 7 days the cumulative fluid balance in the PAC group was significantly lower than in controls (9.4 ± 7.4 versus 13 ± 7.6 litre, P = 0.001). Maximum dose of norepinephrine was significantly higher in the PAC group. Compared to controls this was associated with a significant reduction in ventilator and ICU days. Conclusions. Introduction of a PAC-based treatment protocol in sepsis changed the administration of fluid and vasopressors significantly.
目的。肺动脉导管（PAC）仍是一个有争议的话题。尽管有大量数据，但值得注意的是，许多试验并未纳入治疗方案。方法。我们回顾性评估了在引入基于PAC的治疗方案后脓毒症患者的液体平衡和儿茶酚胺剂量，并与历史对照进行比较。结果。纳入了2组，每组70例患者。在使用PAC的第一天，与对照组相比，该组患者的液体正平衡显著更高（6.1±2.6升对3.8±2.4升，P<0.001）。7天后，PAC组的累积液体平衡显著低于对照组（9.4±7.4升对13±7.6升，P = 0.001）。PAC组去甲肾上腺素的最大剂量显著更高。与对照组相比，这与呼吸机使用天数和重症监护病房（ICU）住院天数的显著减少相关。结论。在脓毒症中引入基于PAC的治疗方案显著改变了液体和血管加压药的使用。
