Safety of heart catheterization questioned for ICU patients
Right heart catheterization may not benefit intensive care unit patients, and in fact, may cause harm, according to researchers at the Case Western Reserve University in Cleveland. They studied 5,735 critically ill patients to evaluate patient survival, length of stay in the hospital and intensive care unit (ICU), hospital costs, and intensity of care for patients who underwent right heart catheterization (RHC) during the first 24 hours of care in the ICU compared to patients who didn’t undergo the procedure.
The investigators found that patients who underwent RHC had a 30-day mortality rate that was 24% higher than patients who didn’t have RHC. Patients with RHC also stayed in the ICU for an average of 14.8 days compared to 13 days for patients not receiving the procedure. Hospital costs average $49,300 for RHC patients compared to $35,700 for those without it. The risk of death within 30 days tended to be higher in the elderly, women, whites, patients with shock or sepsis, and patients who were receiving postoperative care. The researchers say they have "serious concerns" about the study’s results, and that a randomized trial should be undertaken immediately to determine if the catheters should be used at all.
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