Pulmonary artery catheterization in intensive care unit: at what time?

Objectives: Recording the time at which the insertion of a pulmonary artery catheter was decided. Study design: Prospective and descriptive study. Patients: Critically ill patients in an university hospital. Methods: The times at which the insertion of a PAC was decided were recorde d. For each pulmonary artery catheterization, immediate complications were recorded (arterial puncture, pneumothorax, ventricular arrhythmia, hard and failed pulmonary artery catheterization) Results: One hundred and forty-nine patients were included (99 males, age = 63 +/- 15 year, body mass index = 25 +/- 6 kg .m(-2), median Apache II sco re = 16). One hundred and sixty-five PAC insertions were decided (16 patien ts requiring two PACs). Nine arterial punctures, two pneumothoraces, 42 ven tricular arrhythmias, 32 hard and eight failed pulmonary artery catheteriza tions occurred. Thirty-four PAC insertions were decided between 9 and 10 am whereas = 3 PAC insertions per hour were decided between 1 and 9 am. Conclusion: The rate of decision of PAC insertion are decreased during the second half of the night (1 to 9 AM). (C) 2001 Editions scientifiques et me dicales Elsevier SAS.