PAC-MAN Trial

The Lancet

August 6, 2005

Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care.

Summarized by: 

Mazen Kherallah

What was the research question?

  • Does the use of pulmonary artery catheter (PAC)  reduce hospital mortality in critically ill patients?


How did they do it?

  • A randomized controlled trial in 65 ICUs in the UK.

  • 1041 patients were randomized to be managed with PAC (519 patients) or without PAC (522 patients). An alternative cardiac output monitoring device was allowed to be used in the control group.


What did they find?

  • Hospital mortality was not significantly different between the PAC group compared to the no PAC group (68% vs. 66%, p=0.39).

  • There was no difference in the secondary endpoint that included ICU and 28-day mortality, ICU and hospital length of stay.

  • Complications associated with insertion of a PAC was seen in 9.5% of patients.


Are there any limitations?

  • The study did not assess whether physicians interpreted the PAC data appropriately to guide clinical management and decision-making process.


What does it mean?

  • The use of pulmonary artery catheter had no effect on mortality or length of stay in a heterogenous ICU population. PAC was associated with no fatal complications in 9.5% of cases.

PAC-MAN Trial