For a study, researchers sought to investigate the impact of pulmonary artery catheter (PAC) monitoring on cardiogenic shock (CS) survival in light of evidence controversies. The databases MEDLINE, EMBASE, the Cochrane library, and Web of Science were systematically searched to find the most relevant studies on patients with CS comparing PAC use to non-use during hospitalization. The primary endpoint was short-term mortality, and the secondary endpoint was the use of Mechanical Circulatory Support (MCS) devices. About 6 observational studies with a total of 1,166,762 patients were chosen. Post-myocardial infarction was the most common cause of CS (75% [95% CI 55–89%] in the PAC group and 81% [95% CI 47–95%] in the non-PAC group). PAC was used in 33% (95% CI 24–44%) of cases. After adjusting for confounders, there was a significant association between the PAC-group and a reduction in short-term mortality (36% [95% CI 27–45%] vs. 47% [95% CI 35–59%]; Adjusted OR 0.71, 95% CI 0.59–0.87, P<0.01). MCS use was significantly higher in the PAC group compared to the non-PAC group (59% [95% CI 54–65%] vs 48% [95% CI 43–53%]; OR 1.60 [95% CI 1.27–2.02, P<0.01]). PAC was associated with a lower incidence of short-term mortality in CS pooling adjusted observational studies. Prospective research was required to confirm the hypothesis and better understand the mechanisms underlying this potential prognostic benefit.
Source:www.sciencedirect.com/science/article/abs/pii/S0883944122000521
