IL MONITORAGGIO EMODINAMICO NELLO SCOMPENSO CARDIACO a cura di Fabrizio Oliva AREA SCOMPENSO A.N.M.C.O.

Slide 1 IL MONITORAGGIO EMODINAMICO NELLO SCOMPENSO CARDIACO a cura di Fabrizio Oliva AREA SCOMPENSO A.N.M.C.O. Slide 2 Pulmonary Artery Catheter (PAC) Introduction in 1970s PAC is often considered a cornerstone of critical care and a hallmark of the ICU Appoximately 1 million PACs are used annualy in US Physician, equipment and hospital cost in US over $ 2 billion per year Widspread application in the ICU and perioperative setting, despite a lack of high-quality evidence supporting such use AREA SCOMPENSO A.N.M.C.O. Slide 3 Pulmonary Artery Catheter (PAC) Conflicting Data The majority of nonrandomized study in critically ill pts have suggested that PAC is associated with increased morbidity and mortality Conversely some studies showed improved quality of life when the PAC was used to direct a specific therapeutic approach Limits: small sample sizes in heterogeneous populations Clinicians continue to use the PAC in ICUs based on personal experience and the belief that careful monitoring will improve decision making and clinical outcome. AREA SCOMPENSO A.N.M.C.O., Slide 4 ADHERE Registry ProcedureAll patients (N= 105.388) ICU patients ( N= 19754) Defibrillation (%) 1 6 Mechanical ventilation (%) 5 23 Intraaortic baloon pump (%)