PAC-Man

Pulmonary artery catheters for adult intensive care patients

Status: Published 

What was this study about? 

The pulmonary artery catheter (PAC) is monitoring device used in the management of critically ill patients by measuring how well the heart is functioning.  However, there are doubts about its safety.

The PAC-Man Study was a multicentre randomised controlled trial which enrolled 1041 patients from 65 UK intensive care units.  Patients were randomly allocated to management with (n=519) or without (n=522) a PAC.  The timing of insertion and subsequent clinical management were at the discretion of the treating doctor.  Our aim was to find out if using a PAC to manage critically ill patients leads to a reduction in the number of deaths in hospital. 

What did the study find? 

We found no difference in the number of deaths in hospital between patients managed with and without a PAC. Complications directly related to use of a PAC were reported for 10% of patients in whom insertion of a PAC was attempted. None of the complications were fatal.

Our findings indicate no clear evidence of either benefit or harm by managing critically ill patients with a PAC.

Further studies are needed to establish whether managing patients with a PAC can be effective in improving outcomes in specific patient groups. Otherwise, these devices may become an unnecessary technology. 

Who led the study? 

Professor Kathy Rowan, ICNARC

The study was funded by the National Institute for Health Technology (NIHR) – Health Technology Assessment (HTA) Programme (Project: 97/08/03)