Journal of cardiothoracic and vascular anesthesia · 2025
Practice Pattern Variability in the Use of Pulmonary Arterial Catheters in Cardiac Surgery.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
MacKay Emily J, Zhang Bo, Beaty Joseph M, Devine Katelyn A, O'Reilly-Shah Vikas, Mathis Michael R, Szeto Wilson Y, Groeneveld Peter W, Augoustides John G
Аннотация
OBJECTIVES: To quantify intraoperative pulmonary arterial catheter (PAC) use during cardiac surgery and identify hospital-, anesthesiologist-, and patient-level factors associated with PAC utilization.
DESIGN: A cross-sectional, observational study using generalized logistic mixed models to examine variations in PAC use.
SETTING: Fifty-three US academic hospitals participating in the Multicenter Perioperative Outcomes Group (MPOG) national registry PARTICIPANTS: 145,343 adult patients undergoing cardiac surgery between January 1, 2016, and December 31, 2022.
INTERVENTION(S): Receipt of intraoperative PAC, defined by ≥60 minutes of physiologically plausible pulmonary arterial pressures.
MEASUREMENTS & MAIN RESULTS: The primary outcome was PAC utilization. Mixed-effects logistic regression quantified fixed-effect predictors, and variation attributable to anesthesiologists and then to anesthesiologists nested within a hospital was characterized using median odds ratio (MOR). Of the 145,343 cardiac surgeries performed across 53 hospitals, 104,626 (72%) included PAC monitoring. PAC use varied widely across hospitals (0-98%) and across anesthesiologists (0-100%). PAC was used most frequently in heart transplants (94%) and lung transplants (87%) and least frequently in pulmonic valve procedures (30%). A patient's likelihood of receiving a PAC was influenced most strongly by hospital (MOR, 15.00; 95% confidence interval [CI], 8.98-28.32), with substantially less variation attributable to an anesthesiologist within the same hospital (MOR, 1.70; 95% CI, 1.61-1.81).
CONCLUSIONS: Intraoperative PAC monitoring is used in nearly three-quarters of cardiac surgeries at US academic centers, with hospital practice pattern the factor most closely associated with PAC utilization.
DESIGN: A cross-sectional, observational study using generalized logistic mixed models to examine variations in PAC use.
SETTING: Fifty-three US academic hospitals participating in the Multicenter Perioperative Outcomes Group (MPOG) national registry PARTICIPANTS: 145,343 adult patients undergoing cardiac surgery between January 1, 2016, and December 31, 2022.
INTERVENTION(S): Receipt of intraoperative PAC, defined by ≥60 minutes of physiologically plausible pulmonary arterial pressures.
MEASUREMENTS & MAIN RESULTS: The primary outcome was PAC utilization. Mixed-effects logistic regression quantified fixed-effect predictors, and variation attributable to anesthesiologists and then to anesthesiologists nested within a hospital was characterized using median odds ratio (MOR). Of the 145,343 cardiac surgeries performed across 53 hospitals, 104,626 (72%) included PAC monitoring. PAC use varied widely across hospitals (0-98%) and across anesthesiologists (0-100%). PAC was used most frequently in heart transplants (94%) and lung transplants (87%) and least frequently in pulmonic valve procedures (30%). A patient's likelihood of receiving a PAC was influenced most strongly by hospital (MOR, 15.00; 95% confidence interval [CI], 8.98-28.32), with substantially less variation attributable to an anesthesiologist within the same hospital (MOR, 1.70; 95% CI, 1.61-1.81).
CONCLUSIONS: Intraoperative PAC monitoring is used in nearly three-quarters of cardiac surgeries at US academic centers, with hospital practice pattern the factor most closely associated with PAC utilization.