A cost/benefit analysis of randomized invasive monitoring for patients undergoing cardiac surgery

The aim of this study was to determine the effect of choice of invasive monitoring on cost, morbidity, and mortality in cardiac surgery. Two hundred and twenty-six adults undergoing elective cardiac surgery were initially assigned at random to receive either a central venous pressure monitoring catheter (group I), a conventional pulmonary artery (PA) catheter (group II), or a mixed venous oxygen saturation (SJOURNAL/asag/04.02/00000539-198909000-00011/ENTITY_OV0540/v/2017-07-21T015300Z/r/image-pngO2) measuring PA catheter (group III). If the attending anesthesiologist believed that the patient initially randomized to group I should have a PA catheter, that patient was then reassigned to receive either a conventional PA catheter (group IV) or SJOURNAL/asag/04.02/00000539-198909000-00011/ENTITY_OV0540/v/2017-07-21T015300Z/r/image-pngO2 measuring PA catheter (group V). The total costs were defined as the total amount billed to the patient for the catheter used; the professional cost of its insertion; and the determinations of cardiac output, arterial blood gas tensions, hemoglobin level, and hematocrit. Mean total monitoring and laboratory costs in Group I ($591 ± 67) were statistically significantly (P