Key result
Intraoperative pulmonary arterial catheter monitoring was used in 72% of cardiac surgeries, with hospital practice patterns strongly influencing utilization (MOR 15.00; 95% CI 8.98-28.32).
Why the study?
The study was conducted to quantify intraoperative pulmonary arterial catheter use during cardiac surgery and identify hospital-, anesthesiologist-, and patient-level factors associated with its utilization.
What is the prevalence and what factors influence the use of intraoperative pulmonary arterial catheters during cardiac surgery?
Cross-Sectional (n=145,343)
Yes
What is the prevalence and what factors influence the use of intraoperative pulmonary arterial catheters during cardiac surgery?
Odds Ratio: 15 (95% CI 8.98–28.32)
PAC utilization during cardiac surgery is highly variable and primarily driven by hospital-level practice patterns rather than individual anesthesiologist preferences.
Marked variability in PAC use across hospitals and anesthesiologists signals inconsistent practice; leaves open optimal selection criteria for prospective trials.
OBJECTIVES: To quantify intraoperative pulmonary arterial catheter (PAC) use during cardiac surgery and identify hospital-, anesthesiologist-, and patient-level factors associated with PAC utilization. DESIGN: A cross-sectional, observational study using generalized logistic mixed models to examine variations in PAC use. SETTING: Fifty-three US academic hospitals participating in the Multicenter Perioperative Outcomes Group (MPOG) national registry PARTICIPANTS: 145,343 adult patients undergoing cardiac surgery between January 1, 2016, and December 31, 2022. INTERVENTION(S): Receipt of intraoperative PAC, defined by ≥60 minutes of physiologically plausible pulmonary arterial pressures. MEASUREMENTS & MAIN RESULTS: The primary outcome was PAC utilization. Mixed-effects logistic regression quantified fixed-effect predictors, and variation attributable to anesthesiologists and then to anesthesiologists nested within a hospital was characterized using median odds ratio (MOR). Of the 145,343 cardiac surgeries performed across 53 hospitals, 104,626 (72%) included PAC monitoring. PAC use varied widely across hospitals (0-98%) and across anesthesiologists (0-100%). PAC was used most frequently in heart transplants (94%) and lung transplants (87%) and least frequently in pulmonic valve procedures (30%). A patient's likelihood of receiving a PAC was influenced most strongly by hospital (MOR, 15.00; 95% confidence interval [CI], 8.98-28.32), with substantially less variation attributable to an anesthesiologist within the same hospital (MOR, 1.70; 95% CI, 1.61-1.81). CONCLUSIONS: Intraoperative PAC monitoring is used in nearly three-quarters of cardiac surgeries at US academic centers, with hospital practice pattern the factor most closely associated with PAC utilization.
No takes yet. Share an insight, caveat, or question.
MacKay et al. (2025) conducted a cross-sectional in Cardiac surgery (n=145,343). Intraoperative pulmonary arterial catheter (PAC) use vs. No PAC was evaluated on PAC utilization (MOR 15.00, 95% CI 8.98-28.32). Intraoperative pulmonary arterial catheter monitoring was used in 72% of cardiac surgeries, with hospital practice patterns strongly influencing utilization (MOR 15.00; 95% CI 8.98-28.32).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: