Table 2 Summary of the effect of PAC utilization on outcomes of included studies
Study | Patients | PAC insertion | Goal-directed therapy by PAC? | PAC effects on patients’ outcomes | |||
|---|---|---|---|---|---|---|---|
Inclusion criteria | Exclusion criteria | PAC-related complications | Personnel | Benefit | Harm | ||
Schultz 1985 | Hip fracture surgery | ? | ? | ? | Yes, but not described in detail | + | − |
Isaacson 1990 | Pre-op LVEF ≧ 40% | Coronary artery diseases, valvular disease, CHF, RF, FEV1/FVC < 50% | ? | Anesthesiologist | × | − | − |
Shoemaker 1990 | High-risk general surgery | ? | Transient arrhythmia (12%), catheter infection (5%) | ? | CI > 4.5 L/min/m2, DO2 > 600 mL/min/m2, VO2 > 170 mL/min/m2 | + | − |
Berlauk 1991 | Vascular surgery by one surgeon | MI ≦ 3 months, CABG ≦ 6 weeks, unstable angina, valvular disease, CHF | ? | Intensivist | PCWP: 8–14 mmHg, CI ≧ 2.8 L/min/m2, SVR ≦1100 dyne-second/cm5 | + | − |
Bender 1997 | Vascular surgery by one surgeon | MI ≦ 3 months, CABG ≦ 6 weeks, valvular disease, CHF | Transient arrhythmia (6%) | Intensivist | PCWP: 8–14 mmHg, CI ≧ 2.8 L/min/m2, SVR ≦1100 dyne-second/cm5 | + | − |
Valentine 1998 | Abdominal aortic surgery | MI ≦ 3 months, CABG ≦ 6 weeks, unstable angina, valvular disease, RF, CHF | Transient arrhythmia (8%), paroxysmal supraventricular tachycardia (3%) | ? | PCWP: 8–15 mmHg, CI ≧ 2.8 L/min/m2, SVR ≦1100 dyne-second/cm5 | − | − |
Wilson 1999 | Major general, vascular surgery, urology | ? | ? | ? | PCWP: 12 mmHg, DO2 > 600 mL/min/m2 | + | − |
Polanczyk 2001 | Aged ≥ 50 yr, LOS ≥ 2 days | Abdominal aortic surgical patients | ? | ? | × | − | + |
Bonazzi 2002 | Aged < 75 yr, pre-op LVEF ≦ 50% | Chronic obstructive pulmonary disease, RF | Transient arrhythmia (18%), paroxysmal supraventricular tachycardia (4%) | ? | PCWP: 10–18 mmHg, CI ≧ 3.0 L/min/m2, SVR ≦ 1450 dyne-second/cm5, DO2 > 600 mL/min/m2 | − | − |
Sandham 2003 | Aged ≧ 60 yr, ASA III or IV | ? | Hemothorax (0.2%), pneumothorax (0.9%), pulmonary hemorrhages (0.3%), pulmonary infarction (0.1%) | ? | PCWP: 12 mmHg, CI: 3.5–4.5 L/min/m2, DO2: 550–600 mL/min/m2, HR < 120 bpm, Hct > 27%, MAP: 70 mmHg | − | + |
Hofer 2020 | Aged ≧ 18 yr | Combined heart-liver transplantation, patients had orthotopic liver transplantation without TEE or PAC | ? | Anesthesiologist | × | + | + |
Moore 1978 | LM stenosis ≧ 70% | ? | ? | Anesthesiologist | CI: 2.5–4.5 L/min/m2, SVR < 35 Wood, LVFP: 5–15 mmHg, MAP: 80–90 mmHg, HR: 70–90 bpm, RPP ≦ 12000 | + | − |
Pearson 1989 | Aged ≧ 18 yr | ? | ? | ? | Yes, but not described in detail | − | + |
Tuman 1989 | Aged ≧ 18 yr | ? | ? | Anesthesiologist | × | − | − |
Stewart 1998 | Pre-op LVEF ≧ 40%, Scr < 2.0 mg/dL | Chronic obstructive pulmonary disease, unstable angina, pre-op IABP | ? | Anesthesiologist | × | − | + |
Ramsey 2000 | Elective CABG patients at community-based medical centers | ? | ? | ? | × | − | + |
Schwann 2002 | Elective CABG | ? | ? | ? | × | + | − |
Djaiani 2006 | Elective CABG | Valvular disease, pre-op LVEF < 20%, LM stenosis > 70%, pre-op IABP, LBBB, RF | Transient arrhythmia (42%) | Anesthesiologist | × | − | + |
Resano 2006 | Low-risk off-pump CABG | Aged > 75 yr, pre-op LVEF < 35%, emergent or salvage operations, minimally invasive | ? | Anesthesiologist | × | − | − |
Schwann 2011 | Aged ≧ 18 yr | ? | ? | ? | × | − | + |
Chiang 2015 | Elective CABG | ? | ? | ? | × | − | + |
Xu 2015 | Elective CABG | ? | ? | Anesthesiologist | × | − | + |
Brovman 2016 | Elective CABG and VS | Missing data | ? | Anesthesiologist | × | + | - |
Shaw 2018 | Aged ≧ 18 yr | Prior PCI, missing data, hospital LOS < 48 h or > 6 months | ? | ? | × | + | + |
Pasquier 2020 | Pre-op LVEF > 40% | Pulmonary artery hypertension, CS history | ? | ? | × | − | + |
Brown 2022 | Elective-isolated CABG/VS | ? | ? | ? | × | − | + |