CENTRAL VENOUS CATHETER USE IN LOW-RISK CORONARY-ARTERY BYPASS-GRAFTING

Background. To assess the impact of central venous pressure catheter m onitoring in low-risk coronary artery bypass grafting (CABG), we compa red the hospital course of patients undergoing CABG with central venou s pressure catheter monitoring with that of similar patients undergoin g CABG with pulmonary artery catheter monitoring. Methods. All isolate d primary CABG procedures (n = 312) performed between April 22 and Oct ober 31, 1996, were evaluated, and 194 patients meeting six central ve nous pressure catheter use criteria were identified. Of these 194 pati ents, 133 (68%) underwent CABG with central venous pressure catheter m onitoring, and 61 (32%) had pulmonary artery catheter monitoring owing to surgeon or anesthesiologist preference. Results. In-hospital morta lity was similar. A trend toward increased overall complications was s een in the pulmonary artery catheter group. The total volume infused i n the first 12 hours, the 24-hour weight gain, and the intubation time were significantly greater in the pulmonary artery catheter group. In creases in intensive care unit length of stay and in total hospital ch arges trended toward statistical significance in the pulmonary artery catheter group. Conclusions. Pulmonary artery catheter use in low-risk patients undergoing CABG was associated with greater weight gain and longer intubation time and may be associated with increased morbidity and utilization of hospital resources. (Ann Thorac Surg 1998;66:1306-1 1) (C) 1998 by The Society of Thoracic Surgeons