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Comparative Study of Pulmonary Artery Catheter vs Central Venous Catheter in Coronary Artery Bypass Grafting Surgery Patients

Jeevraj Rajawat , Nirav Parikh1 , Jeevraj Rajawat2 , Deepal Prajapati3 , Ramesh Patel4 , Himani Pandya5

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Indian Journal of Anesthesia and Analgesia 6(5):p 1770-1778, September-October 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.40

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Nirav Parikh, Jeevraj Rajawat, Deepal Prajapati et al. Comparative Study of Pulmonary Artery Catheter vs Central Venous Catheter in Coronary Artery Bypass Grafting Surgery Patients. Indian J Anesth Analg. 2019;6(5 P-II):1770-1778.

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Abstract

Background: Pulmonary artery catheter and central venous catheter are an important and integral part of hemodynamic monitoring during coronary artery bypass grafting. Methods: In our prospective randomized survey, 180 patients received either pulmonary artery or central venous catheter after induction of anesthesia. Patients between 35 and 75 years with ejection fraction between 35 and 60% undergoing elective off pump coronary artery bypass grafting surgery were included. Both groups were compared regarding heart rate, mean arterial pressures, serum lactate and central venous saturation, need for inotropes, fluid challenge, blood and blood products use, postoperative complications and ICU stay. Results: There is no statistical difference in heart rate and mean arterial pressure in intra- and postoperative period in both CVC and PA group except in PA group where heart rate was significantly lower after grafting and mean arterial pressure was higher at T6 and T12 hrs. After 48 hours blood lactate level was significant lower in PA catheter groups. Both groups were similar in terms of central venous saturation, intraoperative fluid bolus use, blood, blood products use and output both intraoperative and postoperatively. Use of inotropes particularly noradrenaline and levosemandan was more in PA group. There was no statistically significant difference in respiratory, CNS and Renal complications (p value >0.05), ICU stays >48 hr and mortality in both groups. Conclusion: We can conclude from our study that PAC definitely provides additional information regarding cardiac output and cardiac index in comparisons with CVC but clearly it does not result in significant difference in postoperative ICU stay and outcome of patient in form of morbidity and mortality in coronary artery bypass patients with preserved LV function.

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Nirav Parikh, Jeevraj Rajawat, Deepal Prajapati et al. Comparative Study of Pulmonary Artery Catheter vs Central Venous Catheter in Coronary Artery Bypass Grafting Surgery Patients. Indian J Anesth Analg. 2019;6(5 P-II):1770-1778.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.40

Keywords

Central venous catheter; Pulmonary artery catheter; Coronary artery bypass graft; Peripheral vascular disease.

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