Xie Chun-Mei, Yao Yun-Tai, Qi Wen-Hui, Shen Meng-Qi, He Li-Xian
Department of Anesthesiology, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, 650000 Kunming, Yunnan, China.
Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100037 Beijing, China.
Rev Cardiovasc Med. 2024 May 22;25(5):183. doi: 10.31083/j.rcm2505183. eCollection 2024 May.
Pulmonary artery catheters (PAC) are widely used in patients undergoing off-pump coronary artery bypass (OPCAB) grafting surgery. However, primary data suggested that the benefits of PAC in surgical settings were limited. Therefore, the present study sought to estimate the effects of PAC on the short-term outcomes of patients undergoing OPCAB surgery.
The characteristics, intraoperative data, and postoperative outcomes of consecutive patients undergoing primary, isolated OPCAB surgery from November 2020 to December 2021 were retrospectively extracted. Patients were divided into two groups (PAC and no-PAC) based on PAC insertion status. Data were analyzed with a 1:1 nearest-neighbor propensity score matched-pair in PAC and no-PAC groups.
Of the 1004 Chinese patients who underwent primary, isolated OPCAB surgery, 506 (50.39%) had PAC. Propensity score matching yielded 397 evenly balanced pairs. Compared with the no-PAC group (only implanted a central venous catheter), PAC utilization was not associated with improved in-hospital mortality in the entire or matched cohort. Still, the matched cohort showed that PAC utilization increased epinephrine usage and hospital costs.
The current study demonstrated no apparent benefit or harm for PAC utilization in OPCAB surgical patients. In addition, PAC utilization was more expensive.
肺动脉导管(PAC)广泛应用于非体外循环冠状动脉搭桥(OPCAB)手术患者。然而,初步数据表明PAC在手术环境中的益处有限。因此,本研究旨在评估PAC对接受OPCAB手术患者短期预后的影响。
回顾性提取2020年11月至2021年12月连续接受初次、孤立OPCAB手术患者的特征、术中数据和术后结局。根据PAC置入情况将患者分为两组(PAC组和非PAC组)。对PAC组和非PAC组的数据进行1:1最近邻倾向评分匹配对分析。
在1004例接受初次、孤立OPCAB手术的中国患者中,506例(50.39%)置入了PAC。倾向评分匹配产生了397对均衡匹配的病例。与非PAC组(仅置入中心静脉导管)相比,在整个队列或匹配队列中,使用PAC与住院死亡率改善无关。然而,匹配队列显示,使用PAC增加了肾上腺素的使用量和住院费用。
本研究表明,在OPCAB手术患者中使用PAC没有明显的益处或危害。此外,使用PAC费用更高。