Pulmonary Artery Catheter Use During Cardiac Surgery in the United States, 2010 to 2014

Abstract

Objectives: To examine patterns of use of pulmonary artery catheters in a large cohort of patients undergoing cardiac surgery.

Design: A retrospective study with univariate and multivariate logistic regression to identify independent predictors for the utilization of pulmonary artery catheters.

Setting: University, small, medium and large community hospitals participating in the National Anesthesia Clinical Outcomes Registry.

Participants: A total of 116,333 patients undergoing pulmonary artery catheter placement during cardiac surgery in the National Anesthesia Clinical Outcomes Registry from the Anesthesia Quality Institute.

Measurements and main results: Age older than 50 years, American Society of Anesthesiologists classification of 3 or higher, case duration of longer than 6 hours, and presence of a resident physician or certified nurse anesthetist were associated with increased likelihood of pulmonary artery catheter (PAC) placement. Age<18 years, or presence of a board-certified anesthesiologist, were associated with a decreased likelihood of catheter placement. The use of PACs has increased from 2010 to 2014. The presence of a PAC did not alter the risk of cardiac arrest intraoperatively. A nonsignificant decrease in mortality was associated with catheter placement. Transfusion was 75% less likely in the PAC cohort than in the control group.

Conclusions: Pulmonary artery catheter use remains a mainstay of cardiac anesthesia practice. No significant change in the incidence of intraoperative death was noted, but patients with a PAC were less likely to have blood transfused.

Keywords: anesthesiology; cardiac surgery; outcomes; pulmonary artery catheter.