OUTCOMES OF EARLY-PULMONARY ARTERY CATHETER (PAC) USE IN CARDIOGENIC SHOCK.
Presenter
Juan Del Cid Fratti MD MS, MD MSc, The University of Washington, Peoria, IL
Juan Del Cid Fratti MD MS, MD MSc1, Pablo Paz, MD2, Gaspar Del Rio-Pertuz, MD2 and Erwin Argueta Sosa, MD2, (1)The University of Washington, Peoria, IL, (2)Texas Tech University Health Sciences Center, Lubbock, TX
Keywords: Cardiogenic shock, Hemodynamic support and Quality
Background
The evidence for hemodynamic guided therapy using a pulmonary artery catheter (PAC) in patients with cardiogenic shock (CS) is limited. We aim to describe outcomes of early-PAC in CS.
Methods
We performed a retrospective analysis of the national inpatient sample (NIS) from 2016-2018. Patients with CS were identified. Early-PAC use was defined to be <24h from the index admission. The primary outcome was in-hospital mortality. The secondary outcomes included healthcare utilization burden and in-hospital complications. A multivariate regression analysis was constructed to adjust for confounders.
Results
We identified 431,435 patients with cardiogenic shock, from these 320,730 with non-AMICS and 100,705 with AMICS. Early-PAC was used in 24% of patients with CS. Early-PAC use in CS was associated with decreased mortality, decrease LOS, use of vasopressors, acute kidney injury (AKI) requiring renal replacement therapy (RRT), prolonged mechanical ventilation, Right ventricular failure, acute hepatic failure and discharge to a skilled nursing facility (SNF). Patients with early-PAC use had higher odds of mechanical circulatory support use (MCS) during the index admission.
Conclusions
Early-PAC use in CS is associated with improved in-hospital outcomes. This data supports early-PAC usage and hemodynamic guided therapy for all patients with CS.
