MONDAY, May 22 (HealthDay News) -- Pulmonary-artery catheters (PACs) should not be routinely used in patients with established acute lung injury, according to a study published online May 21 in the New England Journal of Medicine. The findings were released early to coincide with their presentation at the International Conference of the American Thoracic Society in San Diego.
Arthur P. Wheeler, M.D., of the Vanderbilt Medical Center in Nashville, Tenn., and colleagues studied 1,000 patients who had had acute lung injury for 48 hours or less and who had received hemodynamic management guided by a PAC or by a central venous catheter (CVC).
Rates of death during the first 60 days in the hospital were 27.4 percent in the PAC group and 26.3 percent in the CVC group. The two groups were similar in the number of ventilator-free days, the number of days not spent in intensive care, lung and kidney function, rates of hypotension, ventilator settings and use of dialysis or vasopressors. The PAC group, however, experienced approximately double the number of catheter-related complications as were seen in the PVC group. Most of the complications were arrhythmias.
The results "suggest that the PAC should not be routinely used for the management of acute lung injury," the authors conclude. They note, however, that the results do not address the risks and benefits of the PAC for a range of other uses and protocols.
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