An analysis of prior experience influencing quality of pulmonary artery catheter placement in residents

Abstract

Background: Prior experience may be important for successful placement of a pulmonary artery catheter (PAC). However, there is no report about the minimum number of the placement to reach acceptable technique for the catheter placement during residency. Aims: This study was designed to examine quality of the catheter placement and to assess the effect of prior experience. Setting and Design: Prospective, observational, cohort study. Methods: This study included eight residents and one experienced staff in our hospital. We prospectively examined the performance of placement of a PAC in eight residents for the first 2 months of their training period and one staff for previous 2 years. We examined the time required for the catheter placement and probability of ventricular arrhythmias during the placement. Each resident and the staff reported approximate number of past experience of the catheter placement according to the self-statement. In addition, we continued to examine the placement of a PAC in one resident with zero experience to show his improvement. Statistical Analysis: Statistical analysis was performed by Kruskal-Wallis test, Mann-Whitney test, or Fisher's exact test as appropriate and Benjamini and Hochberg method was used for multiple comparisons. Results: The catheter placement time and probability of the ventricular arrhythmias of two residents with zero experience of the placement were significantly larger than those of the staff. On the other hand, the placement quality of the other residents who experienced at least 20 PAC placements was not significantly different from that of the staff. The placement quality of one resident with zero experience became comparable with that of the staff after 20 placements. Conclusion: Our data suggested that about 20 catheter placements may be required to reach acceptable technical level for the PAC placement.