Abstract 13614: Pulmonary Artery Catheter Guided Therapy of Cardiogenic Shock is Associated With Lower Short-Term Mortality: A Systematic Review and Meta-Analysis

Abstract

The utility of pulmonary artery catheterization (PAC) in treatment of cardiogenic shock (CS) is questionable. In this meta-analysis we aimed to evaluate the impact of PAC guided treatment on survival in CS patients. We performed a comprehensive literature search of multiple databases for studies that evaluated the clinical utility of PAC-guided management versus standard care for patients with CS. The primary outcome of interest was short-term mortality. The secondary outcomes were the use of mechanical circulatory support (MCS) and inotropes. Pooled relative risk (RR) and corresponding 95% confidence intervals (CIs) were calculated and combined using random effects model meta-analysis. A total of 9 studies including 364,001 patients with CS (29609 managed with PAC guided therapy vs. 334392 managed with slandered of care) were included in the final analysis. There was a significant difference in short-term mortality favoring PAC guided management (RR:0.83; 95% CI:0.76-0.92; P <0.00001). Standard of care guided management was associated with higher use of MCS and inotropic agents (RR:1.30; 95% CI:1.15-1.46; P <0.0001) and (RR:1.18; 95% CI:1.09-1.29; P <0.001) respectively. Our meta-analysis demonstrates that PAC-guided therapy for patients with CS was associated with lower short-term mortality and a lower likelihood to use MCS and inotropes with their potential associated complications. Further randomized clinical trials are needed to evaluate the utility of PAC as an adjunct tool in the management of CS.