Why the study?
Does a pulmonary-artery-catheter-based treatment protocol alter fluid and catecholamine administration and improve clinical outcomes in early sepsis?
Does a pulmonary-artery-catheter-based treatment protocol alter fluid and catecholamine administration and improve clinical outcomes in early sepsis?
Implementing a PAC-based treatment protocol in early sepsis significantly alters fluid and vasopressor management, ultimately reducing 7-day cumulative fluid balance and decreasing ventilator and ICU days.
Answers are grounded in this paper and cite their sources.
May reduce ventilator/ICU days via lower fluid balance in early sepsis; leaves open whether RCTs confirm PAC benefit.
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.
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Bethlehem et al. (2012) studied this question.
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