Comparison of Pulmonary Artery Catheter and Central Venous Catheter for Early Goal Directed Targeted Therapy in Sepsis and Septic Shock

Gülseren Elay; Ramazan Coşkun; Kürşat Gündoğan; Muhammet Güven; Murat Sungur

doi:10.5152/EurJTher.2019.18020

Authors

Gülseren Elay Clinic of Intensive Care, Dr. Ersin Arslan Training and Research Hospital, Gaziantep https://orcid.org/0000-0003-2166-0545
Ramazan Coşkun Clinic of Intensive Care, Melikgazi Hospital, Kayseri https://orcid.org/0000-0002-5755-523X
Kürşat Gündoğan Department of Internal Medicine and Intensive Care, Erciyes University School of Medicine https://orcid.org/0000-0002-8433-3480
Muhammet Güven Department of Internal Medicine and Intensive Care, Erciyes University School of Medicine, Kayseri https://orcid.org/0000-0001-9874-7185
Murat Sungur Department of Internal Medicine and Intensive Care, Erciyes University School of Medicine, Kayseri https://orcid.org/0000-0002-2492-6129

DOI:

https://doi.org/10.5152/EurJTher.2019.18020

Keywords:

Early goal directed therapy, sepsis, septic shock

Abstract

Objective: The aim of the present study was to compare the effect of the pulmonary artery catheterization (PAC) method and the central venous catheterization (CVC) method on hemodynamic and inflammatory parameters in early goal-directed therapy (EGDT).
Methods: This was a randomized prospective study. Patients with sepsis and septic shock within 12 h of diagnosis were included in the study. Each group received strict protocolized resuscitation for 72 h.
Results: The mean age of the patients was 63.4±14.5 years. The study included 15 (52%) male and 14 (48%) female patients. The length of stay in the hospital and the duration of mechanical ventilation were similar between the two groups. The length of stay in the intensive care unit was shorter in the CVC group (p=0.025). High mobility group box 1 levels were lower at 72 h in the CVC group (p=0.026). In the early resuscitation period, it was found that in the CVC-directed therapy group, the urine output and the mean arterial blood pressure were higher, but vasoconstrictor need was lower (p<0.05).
Conclusion: In the early resuscitation period, CVC-directed therapy is more effective, and rapid correction of hemodynamic parameters results in shorter intensive care unit stay. PAC is not superior to CVC-guided therapy in the late period.

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References

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