An analysis of the factors influencing pulmonary artery catheter placement in anesthetized patients

BACKGROUND: Pulmonary artery catheters are usually placed by resident anesthesiologists with pressure wave monitoring from educational point of view. In some cases, the placement needs longer time or is difficult only by observing the pressure waves. AIMS: We sought to examine the time required for the catheter placement in adult patients and determine factors influencing the placement. SETTINGS AND DESIGNS: Prospective, observational, cohort study. METHODS: We examined the time required for the catheter placement. If the catheter is placed in longer than 5 min, this could be a difficult placement. We examined the effect of the patient's age, body mass index, cardiothoracic ratio (CTR) and tricuspid regurgitation, left ventricular ejection fraction (LVEF) and training duration of a resident on the difficult catheter placement. Next, we excluded the difficult cases from the analysis and examined the effect of these factors on the placement time. STATISTICAL ANALYSIS: The data were analyzed by logistic regression analysis to assess factors for the difficult catheter placement and multiple linear regression analysis to evaluate the factors to increase the placement time after univariate analyses. RESULTS: The difficult placement occurred in 6 patients (5.7%). The analysis showed that LVEF was a significant factor to hinder the catheter placement (P = 0.02) while CTR was a significant factor to increase the placement time (P = 0.002). CONCLUSION: LVEF and CTRs are significant factors to be associated with the difficult catheter placement and to increase the placement time, respectively.