The impact of a pulmonary-artery-catheter-based protocol on fluid and catecholamine administration in early sepsis

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

doi:10.1155/2012/161879

The impact of a pulmonary-artery-catheter-based protocol on fluid and catecholamine administration in early sepsis

Carina Bethlehem, Frouwke M Groenwold, Hanneke Buter, W Peter Kingma, Michael A Kuiper, Fellery de Lange, Paul Elbers, Henk Groen, Eric N van Roon, E Christiaan Boerma

Intensive care medicine

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	161879
Journal	Critical care research and practice
Volume	2012
DOIs	https://doi.org/10.1155/2012/161879
Publication status	Published - 2012

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10.1155/2012/161879

Cite this

@article{c415f7d3c1a44105bf92e58677da2873,

title = "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.",

author = "Carina Bethlehem and Groenwold, {Frouwke M} and Hanneke Buter and Kingma, {W Peter} and Kuiper, {Michael A} and {de Lange}, Fellery and Paul Elbers and Henk Groen and {van Roon}, {Eric N} and Boerma, {E Christiaan}",

year = "2012",

doi = "10.1155/2012/161879",

language = "English",

volume = "2012",

pages = "161879",

journal = "Critical care research and practice",

issn = "2090-1305",

publisher = "Hindawi Limited",

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TY - JOUR

T1 - The impact of a pulmonary-artery-catheter-based protocol on fluid and catecholamine administration in early sepsis

AU - Bethlehem, Carina

AU - Groenwold, Frouwke M

AU - Buter, Hanneke

AU - Kingma, W Peter

AU - Kuiper, Michael A

AU - de Lange, Fellery

AU - Elbers, Paul

AU - Groen, Henk

AU - van Roon, Eric N

AU - Boerma, E Christiaan

PY - 2012

Y1 - 2012

N2 - 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.

AB - 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.

U2 - 10.1155/2012/161879

DO - 10.1155/2012/161879

M3 - Article

C2 - 22454764

VL - 2012

SP - 161879

JO - Critical care research and practice

JF - Critical care research and practice

SN - 2090-1305

ER -