{"title":"肺动脉导管在降低急性心力衰竭心源性休克死亡率方面的疗效:系统性综述","authors":"Brianna Wagaman ACNPC-AG, RN, BSN, CCRN","doi":"10.1016/j.hrtlng.2024.02.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Cardiogenic shock (CS), a complex and life-threatening medical condition, has an astounding hospital mortality rate spanning from 40 % to 59 %. Frequently, CS requires the use of pulmonary artery catheters (PACs) for management.</p></div><div><h3>Objective</h3><p>This literature review aims to investigate the relationship between PAC utilization in CS patients and in-hospital 30-day mortality rates compared to noninvasive vital sign monitoring alone.</p></div><div><h3>Methods</h3><p>An integrative literature search was conducted from January 1, 2003, until August 1, 2023. The review focused on patients with acute decompensated heart failure CS. It compared PAC and non-PAC hemodynamic monitoring with 30-day mortality outcomes. Five articles met the inclusion criteria and underwent quality assessment using CONSORT, STROBE, and STARD guidelines.</p></div><div><h3>Results</h3><p>Five articles totaled 332,794 patients. Patients with a PAC showed lower 30-day in-hospital mortality rates (22.2 % to 55 %) than patients without a PAC (29.8–78 %). One study, however, indicated that PAC use did not significantly affect mortality rates (<em>p</em> = 0.66). Notably, the lowest mortality rates (25 %) were linked to complete hemodynamic profiling with a PAC.</p><p>The mortality rates showed greater significance when PAC initiation occurred early, resulting in a further reduction of the mortality rate to 17.3 %. Conversely, mortality rates increased to 27.7 % with delayed PAC initiation, 40 % with incomplete hemodynamic profiling, and 35 % with no PAC use.</p></div><div><h3>Conclusions</h3><p>PAC utilization reduces in-hospital mortality for the CS patient population, as suggested by the analyzed studies. Further research via randomized controlled trials (RCTs) with standardized treatment protocols and adequate follow-up are required to validate the findings.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The efficacy of pulmonary artery catheters in reducing mortality in acute heart failure cardiogenic shock: A systematic review\",\"authors\":\"Brianna Wagaman ACNPC-AG, RN, BSN, CCRN\",\"doi\":\"10.1016/j.hrtlng.2024.02.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Cardiogenic shock (CS), a complex and life-threatening medical condition, has an astounding hospital mortality rate spanning from 40 % to 59 %. Frequently, CS requires the use of pulmonary artery catheters (PACs) for management.</p></div><div><h3>Objective</h3><p>This literature review aims to investigate the relationship between PAC utilization in CS patients and in-hospital 30-day mortality rates compared to noninvasive vital sign monitoring alone.</p></div><div><h3>Methods</h3><p>An integrative literature search was conducted from January 1, 2003, until August 1, 2023. The review focused on patients with acute decompensated heart failure CS. It compared PAC and non-PAC hemodynamic monitoring with 30-day mortality outcomes. Five articles met the inclusion criteria and underwent quality assessment using CONSORT, STROBE, and STARD guidelines.</p></div><div><h3>Results</h3><p>Five articles totaled 332,794 patients. Patients with a PAC showed lower 30-day in-hospital mortality rates (22.2 % to 55 %) than patients without a PAC (29.8–78 %). One study, however, indicated that PAC use did not significantly affect mortality rates (<em>p</em> = 0.66). Notably, the lowest mortality rates (25 %) were linked to complete hemodynamic profiling with a PAC.</p><p>The mortality rates showed greater significance when PAC initiation occurred early, resulting in a further reduction of the mortality rate to 17.3 %. Conversely, mortality rates increased to 27.7 % with delayed PAC initiation, 40 % with incomplete hemodynamic profiling, and 35 % with no PAC use.</p></div><div><h3>Conclusions</h3><p>PAC utilization reduces in-hospital mortality for the CS patient population, as suggested by the analyzed studies. Further research via randomized controlled trials (RCTs) with standardized treatment protocols and adequate follow-up are required to validate the findings.</p></div>\",\"PeriodicalId\":55064,\"journal\":{\"name\":\"Heart & Lung\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-04-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart & Lung\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0147956324000335\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0147956324000335","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
The efficacy of pulmonary artery catheters in reducing mortality in acute heart failure cardiogenic shock: A systematic review
Background
Cardiogenic shock (CS), a complex and life-threatening medical condition, has an astounding hospital mortality rate spanning from 40 % to 59 %. Frequently, CS requires the use of pulmonary artery catheters (PACs) for management.
Objective
This literature review aims to investigate the relationship between PAC utilization in CS patients and in-hospital 30-day mortality rates compared to noninvasive vital sign monitoring alone.
Methods
An integrative literature search was conducted from January 1, 2003, until August 1, 2023. The review focused on patients with acute decompensated heart failure CS. It compared PAC and non-PAC hemodynamic monitoring with 30-day mortality outcomes. Five articles met the inclusion criteria and underwent quality assessment using CONSORT, STROBE, and STARD guidelines.
Results
Five articles totaled 332,794 patients. Patients with a PAC showed lower 30-day in-hospital mortality rates (22.2 % to 55 %) than patients without a PAC (29.8–78 %). One study, however, indicated that PAC use did not significantly affect mortality rates (p = 0.66). Notably, the lowest mortality rates (25 %) were linked to complete hemodynamic profiling with a PAC.
The mortality rates showed greater significance when PAC initiation occurred early, resulting in a further reduction of the mortality rate to 17.3 %. Conversely, mortality rates increased to 27.7 % with delayed PAC initiation, 40 % with incomplete hemodynamic profiling, and 35 % with no PAC use.
Conclusions
PAC utilization reduces in-hospital mortality for the CS patient population, as suggested by the analyzed studies. Further research via randomized controlled trials (RCTs) with standardized treatment protocols and adequate follow-up are required to validate the findings.
期刊介绍:
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.