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Effects of pulse indicated continuous cardiac output monitoring on outcomes of intensive care unit patients with shock:a propensity score matching analysis

摘要BACKGROUND:Pulse indicated continuous cardiac output(PiCCO)has largely replaced Swan-Ganz catheterization in shock patients.However,whether PiCCO monitoring can improve outcomes of shock patients,such as mortality,length of hospital stay,duration of mechanical ventilation,or laboratory parameters,remains unknown.METHODS:This retrospective cohort study included patients with shock in the intensive care unit(ICU)from January 2013 to January 2020.Patients were divided into PiCCO group and non-PiCCO group based on treatment with PiCCO monitoring or not.Demographic characteristics,Acute Physiology and Chronic Health Evaluation(APACHE)II scores,quick Sequential Organ Failure Assessment(qSOFA)scores,14-day mortality,and N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels at 0,1,3 and 7 days after onset of shock,duration of mechanical ventilation,length of hospital stay and hospitalization costs were compiled and analyzed using propensity score matching(PSM).RESULTS:Real-world analysis of 1,583 ICU patients suffering shock after propensity score matching revealed that 14-day mortality did not differ between PiCCO and non-PiCCO groups(36.2%vs.32.6%,P=0.343).Duration of mechanical ventilation,hospital stay,and hospitalization costs were also similar between the two groups(P>0.05).No differences in changes of NT-proBNP levels on days 0,1,3,and 7 as compared to baseline were noted between the two groups(P>0.05).CONCLUSIONS:The results of our real-world indicate that PiCCO monitoring may not shorten the duration of mechanical ventilation,length of hospital stay,or reduce hospitalization costs,nor will it bring survival benefits to ICU patients suffering shock.

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