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.