Abstract
There is controversy around the use of the pulmonary artery catheter (PAC) in guiding the management of cardiogenic shock (CS) based on the ESCAPE trial (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) and other studies, which showed there was no benefit from PAC monitoring. The use of PAC has decreased over the years, although those studies did not enroll patients with CS. 1 Binanay C Califf RM Hasselblad V O'Connor CM Shah MR Sopko G Stevenson LW Francis GS Leier CV Miller LW ESCAPE Investigators and ESCAPE Study Coordinators. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA. 2005; 294: 1625-1633 Crossref PubMed Scopus (987) Google Scholar , 2 Harvey S Harrison DA Singer M Ashcroft J Jones CM Elbourne D Brampton W Williams D Young D Rowan K PAC-Man study collaboration. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet. 2005; 366: 472-477 Abstract Full Text Full Text PDF PubMed Scopus (791) Google Scholar , 3 Richard C Warszawski J Anguel N Deye N Combes A Barnoud D Boulain T Lefort Y Fartoukh M Baud F Boyer A Brochard L Teboul JL French Pulmonary Artery Catheter Study Group. Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2003; 290: 2713-2720 Crossref PubMed Scopus (511) Google Scholar More notable is that PAC use has not been studied as part of a randomized, controlled trial in patients with CS with or without mechanical circulatory support (MCS). 4 Saxena A Garan AR Kapur NK O'Neill WW Lindenfeld J Pinney SP Uriel N Burkhoff D Kern M. Value of hemodynamic monitoring in patients with cardiogenic shock undergoing mechanical circulatory support. Circulation. 2020; 141: 1184-1197 Crossref PubMed Scopus (63) Google Scholar Existing data obtained from the study population without CS have revealed contradictory results. 5 Hadian M Pinsky MR. Evidence-based review of the use of the pulmonary artery catheter: impact data and complications. Crit Care. 2006; 10: S8 Crossref PubMed Scopus (115) Google Scholar
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