title: The impact of a pulmonary-artery-catheter-based protocol on fluid and catecholamine administration in early sepsis.
abstract: Objective. The pulmonary artery catheter (PAC) remains topic of debate. Despite abundant data, it is of note that many trials did not incorporate a treatment protocol. Methods. We retrospectively evaluated fluid balances and catecholamine doses in septic patients after the introduction of a PAC-based treatment protocol in comparison to historic controls. Results. 2 × 70 patients were included. The first day the PAC group had a significantly higher positive fluid balance in comparison to controls (6.1 ± 2.6 versus 3.8 ± 2.4 litre, P < 0.001). After 7 days the cumulative fluid balance in the PAC group was significantly lower than in controls (9.4 ± 7.4 versus 13 ± 7.6 litre, P = 0.001). Maximum dose of norepinephrine was significantly higher in the PAC group. Compared to controls this was associated with a significant reduction in ventilator and ICU days. Conclusions. Introduction of a PAC-based treatment protocol in sepsis changed the administration of fluid and vasopressors significantly.
authors.affiliation: Department of Intensive Care, Medical Centre Leeuwarden, P.O. Box 888, 8901 BR Leeuwarden, The Netherlands.
authors.forename: Carina
authors.initials: C
authors.lastname: Bethlehem
authors.forename: Frouwke M
authors.initials: FM
authors.lastname: Groenwold
authors.forename: Hanneke
authors.initials: H
authors.lastname: Buter
authors.forename: W Peter
authors.initials: WP
authors.lastname: Kingma
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kuiper
authors.forename: Fellery
authors.initials: F
authors.lastname: de Lange
authors.forename: Paul
authors.initials: P
authors.lastname: Elbers
authors.forename: Henk
authors.initials: H
authors.lastname: Groen
authors.forename: Eric N
authors.initials: EN
authors.lastname: van Roon
authors.forename: E Christiaan
authors.initials: EC
authors.lastname: Boerma