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

Abstract

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.