The association of pulmonary artery catheterization utilization and surgical patients’ outcomes: a PRISMA-compliant systematic review and meta-analysis

BACKGROUND: The utilization of pulmonary artery catheterization (PAC) in surgical patients remains controversial. This study aims to assess the impact of PAC utilization on surgical patient outcomes. METHODS: Electronic databases were searched for studies comparing PAC with no-PAC in surgical patients. The primary outcome was short-term mortality. Secondary outcomes included the incidence of postoperative complications, postoperative recovery indicators, and hospitalization costs. RESULTS: Ten randomized controlled trials (n = 2,889) and sixteen observational studies (n = 2,221,917) were included. Among these studies, fifteen involved cardiac surgical patients (n = 2,217,736), and eleven involved non-cardiac surgical patients (n = 7,070). The present study demonstrated PAC utilization did not affect short-term mortality in cardiac surgical patients [odds ratio (OR) 1.20, 95% confidence interval (CI) 0.79-1.82, p 0.40], and was associated with a higher incidence of postoperative chronic heart failure, acute renal failure, cerebrovascular events, infectious complications, and longer length of stay (LOS) in intensive care unit (ICU) or hospital. Moreover, PAC utilization was not associated with short-term mortality (OR 0.40, 95% CI 0.16-1.02, p 0.06) and other outcomes for non-cardiac surgical patients. CONCLUSIONS: This meta-analysis suggested PAC utilization was not associated with short-term mortality in surgical patients but with a higher incidence of major complications and longer LOS in the ICU or hospital in cardiac surgical patients.