The Impact of a Pulmonary-Artery-Catheter-Based Protocol on Fluid and Catecholamine Administration in Early Sepsis | Zendy

Carina Bethlehem | Zendy; Frouwke M. Groenwold | Zendy; Hanneke Buter | Zendy; W. Peter Kingma | Zendy; Michaël Kuiper | Zendy; Fellery de Lange | Zendy; Paul Elbers | Zendy; Henk Groen | Zendy; Eric N. van Roon | Zendy; E. Christiaan Boerma | Zendy

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The Impact of a Pulmonary-Artery-Catheter-Based Protocol on Fluid and Catecholamine Administration in Early Sepsis

Author(s) -

Carina Bethlehem,

Frouwke M. Groenwold,

Hanneke Buter,

W. Peter Kingma,

Michaël Kuiper,

Fellery de Lange,

Paul Elbers,

Henk Groen,

Eric N. van Roon,

E. Christiaan Boerma

Publication year - 2012

Publication title -

critical care research and practice

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.532

H-Index - 27

eISSN - 2090-1313

pISSN - 2090-1305

DOI - 10.1155/2012/161879

Subject(s) - medicine , pulmonary artery catheter , sepsis , catecholamine , anesthesia , norepinephrine , catheter , fluid intake , balance (ability) , randomized controlled trial , pulmonary artery , surgery , hemodynamics , cardiac output , physical therapy , dopamine

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.

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