title: [The application of peripartum use of pulmonary artery catheter in pregnant patients with pulmonary hypertension].
abstract: OBJECTIVE
  To investigate the application and value of pulmonary artery catheterization (PAC) in pregnant patients with pulmonary hypertension (PH).
  
  
  METHODS
  The clinical data of pregnant patients with PH who were treated between 2006 and 2014 in surgical intensive care unit (SICU) at Capital Medical University affiliated Beijing Anzhen Hospital were retrospectively analysed. The differences of the clinical characteristics and outcome between PAC inserted patients and PAC not inserted patients were compared.
  
  
  RESULTS
  The systolic pulmonary artery pressure (sPAP) measured by preoperative echocardiography has no significant difference between the PAC inserted patients [(103.0 ± 24.1) mmHg (1 mmHg = 0.133 kPa)] and PAC not inserted patients [(96.4 ± 27.3) mmHg; P = 0.175]. SPAP may be overestimated or underestimated by echocardiography compared with PAC with a gap from -38.4 mmHg to 49.5 mmHg. The rates of idiopathic pulmonary arterial hypertension (20.0% vs 3.2%) and continuous use of epidural anesthesia (89.1% vs 65.1%) were higher in PAC inserted patients compared with PAC not inserted patients. Norepinephrine, dobutamine, sildenafil, alprostadil, iloprost and low molecular weight heparin were more widely used in PAC inserted patients. The mortality rate and the rates of low birth weight (63.9% vs 30.6%) and very low birth weight infants (19.4% vs 13.9%) were all higher in PAC inserted patients, while the rate of induced abortion was lower in this group (5.5% vs 17.5%). The length of stay in surgical intensive care unit [6.0 (5.0) d vs 1.0 (3.0) d], postoperative length of stay [8.0 (6.0) d vs 8.0 (4.0) d] and total hospital costs [43 999.22 (38 267.27) RMB vs 14 878.24 (10 564.47) RMB] were all higher in PAC inserted patients. The incidence rate of PAC related complications was 7.3%.
  
  
  CONCLUSIONS
  In moderate or severe PH pregnant patients with severe clinical symptoms, perioperative insertion of PAC helps to monitor the perinatal pulmonary arterial pressure(PAP) and guide treatment, potentially improving clinical outcomes and lowering the short term mortality. PAC can't be replaced by echocardiography in measuring PAP.
authors.forename: Tengke
authors.initials: T
authors.lastname: Wang
authors.forename: Jiakai
authors.initials: J
authors.lastname: Lu
authors.forename: Yao
authors.initials: Y
authors.lastname: Chen
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Qing
authors.initials: Q
authors.lastname: Ye
authors.forename: Jie
authors.initials: J
authors.lastname: Gao
authors.forename: Jianping
authors.initials: J
authors.lastname: Sun
authors.forename: Limin
authors.initials: L
authors.lastname: Geng
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.forename: Yanna
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Surgical Intensive Care Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China; Email: jinglanzhang2006@aliyun.com.
authors.forename: Jinglan
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000068476:Beijing; D016022:Case-Control Studies; D002407:Catheterization, Swan-Ganz; D004452:Echocardiography; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000601:surgery*; D007223:Infant; D007362:Intensive Care Units; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D011256:Pregnancy Outcome; D011651:Pulmonary Artery; D012189:Retrospective Studies; D000068677:Sildenafil Citrate / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D000068677:Sildenafil Citrate