• Maurizio Bertaina, Alessandro Galluzzo, Xavier Rossello, Pierluigi Sbarra, Elisabetta Petitti, Silvia Brach Prever, Giacomo Boccuzzi, Fabrizio D'Ascenzo, Simone Frea, Stefano Pidello, Nuccia Morici, Alice Sacco, Fabrizio Oliva, Serafina Valente, Gaetano Maria De Ferrari, Fabrizio Ugo, Francesco Rametta, Matteo Attisani, Paola Zanini, Patrizia Noussan, and Mario Iannaccone.
• Department of Cardiology, San Giovanni Bosco Hospital, Turin, Italy. Electronic address: maurizio.bertaina@aslcittaditorino.it.
• J Crit Care. 2022 Jun 1; 69: 154024.

PurposeTo investigate the impact of pulmonary artery catheter (PAC) monitoring on survival of cardiogenic shock(CS), in the light of the controversies in available evidence.Materials And MethodsMEDLINE, EMBASE, Cochrane library and Web of Science were systematically screened to identify most relevant studies on patients with CS comparing PAC use to non-use during hospital stay. Short-term mortality was the primary endpoint and the use of Mechanical Circulatory Support (MCS) devices was the secondary one.ResultsSix observational studies including 1,166,762 patients were selected. The most frequent etiology of CS was post-myocardial infarction (75% [95% CI 55-89%] in PAC-group and 81%[95% CI 47-95%] in non-PAC group). Overall, PAC was used in 33%(95% CI 24-44%) of cases. Pooling data adjusted for confounders, a significant association between the PAC-group and a reduction in short-term mortality emerged when compared to the non-PAC group (36%[95% CI 27-45%] vs 47%[95% CI 35-59%];AdjustedOR 0.71, 95% CI 0.59-0.87, p < 0.01). MCS use was significantly higher in PAC vs non-PAC group (59% [95% CI 54-65%]) vs 48% [95% CI 43-53%]);OR 1.60 [95% CI 1.27-2.02, p < 0.01]).ConclusionsPAC was associated with lower incidence of short-term mortality in CS pooling adjusted observational studies. Prospective studies are needed to confirm our hypothesis and better clarify the mechanisms of this potential prognostic benefit.Copyright © 2022 Elsevier Inc. All rights reserved.

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