Monday, November 07, 2005

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Monday November 7, 2005
ESCAPE Trial - setback to swan lovers?


Debate on pulmonary artery catheter is non-ending in critical care culture. Recently JAMA has published 2 studies which may make swan-believers unhappy.

1. ESCAPE Trial (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness): which showed that use of the PAC did not significantly affect the primary end point of days alive and out of the hospital during the first 6 months. Also, In-hospital adverse events were more common among patients in the PAC group.

2. Impact of the Pulmonary Artery Catheter in Critically Ill Patients - Meta-analysis of 13 Randomized Clinical Trials which showed that in critically ill patients, use of the PAC neither increased overall mortality or days in hospital nor conferred benefit.

Now we have to wait for results of FACTT study from ARDSnet evaluating the use of a Pulmonary Artery Catheter versus Central Venous Catheter (CVP) in patients with Acute Lung Injury and ARDS.

Refrences: click on link to get article/abstract
1.
The ESCAPE Trial JAMA. 2005;294:1625-1633
2.
Impact of the Pulmonary Artery Catheter in Critically Ill Patients -JAMA. 2005;294:1664-1670.
3.
FACTT trial - ARDSNet