Therapy guided by pulmonary artery catheter for high-risk surgical patients was not better than standard care

November 2003
ACP Journal Club;Nov/Dec2003, Vol. 139 Issue 3, p66
Academic Journal
This article discusses whether a therapy guided by a pulmonary artery catheter (PAC) more effective than standard care in older, high-risk patients having urgent or elective major surgery. Patients were allocated to therapy guided by a PAC or standard care. The PAC group has received prioritized goal-directed treatment according to physiologic goals: oxygen delivery index 550 to 600 mL/min per m² of body surface area, cardiac index 3.5 to 4.5 L/min per m², mean arterial pressure 70 mm Hg, pulmonary-capillary wedge pressure 18 mm Hg, heart rate< 120 beats/ min, and hematocrit> 27% based on highest value obtained. Patients had a minimum 24-hour postoperative stay in the intensive care unit. The groups did not differ for in-hospital mortality.


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