6/29/23, 1:34 AM PAC in high-risk surgery Pathway Feedback Search Clinical Topics Home Studies PAC in high-risk surgery PAC in high-risk surgery Trial question What is the role of goal-directed therapy guided by a pulmonary artery catheter in high-risk surgical patients? Study design Multi-center Open label RCT Population Characteristics of study participants 29.0% female N = 1994 71.0% male 1994 patients (576 female, 1418 male) Inclusion criteria: high-risk adult patients aged 60 years who were scheduled for urgent or elective major surgery, followed by a stay in the ICU Key exclusion criteria: lack of available beds in the ICU; no informed consent; no referral by the treating physician Interventions N=997 pulmonary artery catheter (goal-directed therapy guided by a pulmonary artery catheter) N=997 no pulmonary artery catheter (standard of care without the use of a pulmonary artery catheter) Primary outcome Death in hospital 7.8 % 7.8 7.7 5.8 % 3.9 % https://web.pathway.md/studies/recFHopvaDc2zJMZb 1/2 6/29/23, 1:34 AM PAC in high-risk surgery Pathway 1.9 % No significant difference 0.0 % Pulmonary artery catheter No pulmonary artery catheter No significant difference in death in the hospital (7.8% vs. 7.7%; AD 0.1%, 95% CI -2.3 to 2.5) Secondary outcomes Significant increase in PE (AD 0.9%, 95% CI 0.29 to 1.51) No significant difference in survival at 12 months (83% vs. 83.9%; ARD -0.9, 95% CI -4.3 to 2.4) Safety outcomes No significant difference in adverse events due to pulmonary artery catheters or central venous catheters. Conclusion In high-risk adult patients aged 60 years who were scheduled for urgent or elective major surgery, followed by a stay in the ICU, pulmonary artery catheter was not superior to no pulmonary artery catheter with respect to death in the hospital. Reference James Dean Sandham, Russell Douglas Hull, Rollin Frederick Brant et al. A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med. 2003 Jan 2;348(1):5-14. Open reference URL https://web.pathway.md/studies/recFHopvaDc2zJMZb 2/2