OBJECTIVE: To assess the clinical utility of protective sleeves in pulmonary artery (PA) balloon flotation catheters. DESIGN: Prospective, randomized trial with cost-effectiveness analysis. SETTING: A general adult ICU in a community teaching hospital. PATIENTS: All patients receiving PA balloon flotation catheters over a 1-yr period. INTERVENTIONS: Groups 1 and 2 received PA catheters with and without protective sleeves, respectively. Indications for catheter changes, other than catheter malposition, were the same for both groups. MEASUREMENTS AND MAIN RESULTS: In group 1, 54 patients received 71 catheters and four catheters were replaced due to the inability to obtain a PA occlusion pressure (PAOP) tracing. In group 2, 48 patients received 66 catheters, 11 of which were inserted due to failure to obtain a PAOP (p less than .05). PA catheters were repositioned successfully in 37/56 attempts in group 1, compared with 8/20 attempts in group 2 (p less than .05). There was no significant difference in complication rates between the two groups. Even at the increased cost of the protective sleeves and introducer ($7/kit), for 100 catheter insertions, we project a direct cost savings of $742, and personnel time savings of 10.5 hrs for physicians, 14 hrs for nurses, and 4.7 hrs for radiology technicians. CONCLUSION: Protective sleeves on PA catheters are safe, effective, cost-saving devices for ICU patients.
RCT Entities:
OBJECTIVE: To assess the clinical utility of protective sleeves in pulmonary artery (PA) balloon flotation catheters. DESIGN: Prospective, randomized trial with cost-effectiveness analysis. SETTING: A general adult ICU in a community teaching hospital. PATIENTS: All patients receiving PA balloon flotation catheters over a 1-yr period. INTERVENTIONS: Groups 1 and 2 received PA catheters with and without protective sleeves, respectively. Indications for catheter changes, other than catheter malposition, were the same for both groups. MEASUREMENTS AND MAIN RESULTS: In group 1, 54 patients received 71 catheters and four catheters were replaced due to the inability to obtain a PA occlusion pressure (PAOP) tracing. In group 2, 48 patients received 66 catheters, 11 of which were inserted due to failure to obtain a PAOP (p less than .05). PA catheters were repositioned successfully in 37/56 attempts in group 1, compared with 8/20 attempts in group 2 (p less than .05). There was no significant difference in complication rates between the two groups. Even at the increased cost of the protective sleeves and introducer ($7/kit), for 100 catheter insertions, we project a direct cost savings of $742, and personnel time savings of 10.5 hrs for physicians, 14 hrs for nurses, and 4.7 hrs for radiology technicians. CONCLUSION: Protective sleeves on PA catheters are safe, effective, cost-saving devices for ICU patients.