The value of pulmonary artery and central venous monitoring in patients undergoing abdominal aortic reconstructive surgery: a comparative study of two selected, randomized groups.
One hundred two patients undergoing abdominal aortic reconstructive surgery were prospectively, randomly allocated to two groups, one of which was monitored with a central venous catheter and the other with a pulmonary artery catheter. Patients with uncompensated cardiopulmonary or renal disease were excluded from the study. General anesthesia was administered for the surgical procedure, and the patients were followed through hospital discharge. No statistically significant differences occurred between the two groups with regard to morbidity (perioperative cardiac, pulmonary or renal sequelae), mortality rate, duration of intensive care, postoperative hospital stay, or cost of hospitalization. The one statistically significant difference between groups was the professional fee charged for anesthetic care, which was higher for patients with pulmonary artery catheters than for those with central venous catheters. In conclusion, we prospectively gathered data from most patients presented for abdominal aortic reconstructive surgery. Our data seem to indicate that the choice of central venous catheter or pulmonary artery catheter monitoring makes little difference in outcome after abdominal aortic reconstructive surgery, and that for many patients pulmonary artery catheters are not necessary to give appropriate, adequate care. Because of the size of the sample, however, declarations of epidemiologic significance would be unfounded. Therefore large-scale, multicenter studies addressing such outcomes remain necessary.
Isaacson
I J
IJ
Emory University Hospital, Atlanta, GA.
Lowdon
J D
JD
Berry
A J
AJ
Smith
R B
RB
Knos
G B
GB
Weitz
F I
FI
Ryan
K
K
D000768:Anesthesia, General; D001012:Aorta, Abdominal / Q000601:surgery*; D001018:Aortic Diseases / Q000191:economics / Q000503:physiopathology / Q000601:surgery; D002496:Central Venous Pressure; D003327:Coronary Disease / Q000175:diagnosis; D003365:Costs and Cost Analysis; D005069:Evaluation Studies as Topic; D006439:Hemodynamics; D006801:Humans; D016343:Monitoring, Intraoperative / Q000191:economics / Q000379:methods*; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology*; D011897:Random Allocation