Use of a Pulmonary Artery Catheter in Patients With Cardiogenic Shock　― A Systematic Review and Meta-Analysis ―

DOI Web Site 参考文献46件
  • Kondo Toru
    Department of Cardiology, Nagoya University Graduate School of Medicine
  • Nakashima Takahiro
    Department of Cardiovascular Medicine, Kumamoto University Hospital
  • Yamamoto Takeshi
    Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
  • Nakayama Naoki
    Department of Cardiovascular Medicine, Kumamoto University Hospital
  • Hanada Hiroyuki
    Emergency, Disaster and General Medicine, Hirosaki University Graduate School of Medicine
  • Hashiba Katsutaka
    Department of Cardiology, Yokosuka General Medical Center
  • Kirigaya Jin
    Department of Cardiology, Yokohama City University Medical Center
  • Ishizu Tomoko
    Department of Cardiology, University of Tsukuba Hospital
  • Hosoya Yumiko
    Department of Cardiology, Sakakibara Heart Institute
  • Katasako-Yabumoto Aya
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Okazaki Yusuke
    Department of Cardiology, Steel Memorial Muroran Hospital
  • Yamamoto Masahiro
    Department of Cardiovascular Medicine, Kumamoto University Hospital
  • Sakamoto Kazuo
    Department of Cardiology/Coronary Care Unit, Kyushu University Hospital
  • Arai Marina
    Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Osawa Takumi
    Department of Cardiology, University of Tsukuba Hospital
  • Tanaka Akihito
    Department of Cardiology, Nagoya University Graduate School of Medicine
  • Matsuo Kunihiro
    Department of Cardiology, Fukuoka Tokushukai Hospital
  • Yamaguchi Junichi
    Department of Cardiology, Tokyo Women’s Medical University
  • Mano Toshiaki
    Cardiovascular Center, Kansai Rosai Hospital
  • Kojima Sunao
    Department of Cardiovascular Medicine, Kumamoto University Hospital Department of Cardiovascular Medicine, Sakurajyuji Yatsushiro Rehabilitation Hospital
  • Noguchi Teruo
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Tsujimoto Yasushi
    Systematic Review Workshop Peer Support Group (SRWS-PSG) Oku Medical Clinic
  • Kikuchi Migaku
    Emergency and Critical Care Center, Dokkyo Medical University
  • Funazaki Toshikazu
    Department of Cardiovascular Medicine, Kawaguchi Cupola Rehabilitation Hospital
  • Tahara Yoshio
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Nonogi Hiroshi
    Pharmaceutical Sciences, University of Shizuoka
  • Matoba Tetsuya
    Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences

説明

<p>Background: A pulmonary artery catheter (PAC) provides detailed hemodynamic data, and managing a patient with cardiogenic shock (CS) using a PAC potentially improves patient outcomes. Therefore, in this systematic review and meta-analysis we aimed to evaluate whether a PAC is associated with better outcomes in patients with CS.</p><p>Methods and Results: Studies comparing PAC and non-PAC management in patients with CS were identified from the PubMed, Web of Science, and CENTRAL databases. There were no randomized controlled trials (RCTs). Of the 19 studies that met the inclusion criteria, 12 without a critical risk of bias were analyzed. PAC use was associated with lower in-hospital mortality when evaluated as a dichotomous outcome. Similar trends were observed in the time-to-event analyses. Substantial heterogeneity was observed across the studies. Subgroup analysis revealed better outcomes with PAC in patients with CS related to heart failure, but not in those with acute coronary syndrome. Sensitivity analyses, which included studies with a critical risk of bias, showed consistent trends favoring PAC use for crude in-hospital mortality. The overall certainty of the evidence was very low because of inconsistencies and biases.</p><p>Conclusions: The PAC-guided CS management was associated with better in-hospital mortality, particularly in patients with heart failure-related CS. However, RCTs that evaluated the efficacy of PAC use as a primary purpose were not included, necessitating further RCTs to confirm these findings.</p>

収録刊行物

  • Circulation Reports

    Circulation Reports 7 (8), 589-598, 2025-08-08

    一般社団法人 日本循環器学会

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