On 2014 Mar 07, Preben Berthelsen commented:

A foregone conclusion.

The result of this investigation was a dead certainty even before it was conducted. The authors initiating PAC guided therapy 18 hours after the critically ill patients were admitted to intensive care units. This delay in the deployment of the PAC makes it extremely unlikely that PAC guided therapy would influence the mortality rate; it is like shutting the stable door after the horse has bolted. This study does not inform on the timely use of the pulmonary artery catheter.

The primary sample size calculation stipulated that 5673 patients were needed to demonstrate a 5% reduction in mortality. Due to slow recruitment, the primary endpoint was changed to a 10% reduction - 1281 patients were then required. In the end, the authors report the results from 1014 patients.

The principal clinical investigator/corresponding author M. Singer “does consultancy work for, and receives research funds from Deltex Medical, manufacturers of the CardioQ oesophageal Doppler device.”

Preben G. Berthelsen MD

Charlottenlund, Denmark

On 2014 Mar 07, Preben Berthelsen commented:

None

On 2014 Mar 07, Preben Berthelsen commented:

None

On 2014 Mar 07, Preben Berthelsen commented:

A foregone conclusion.

The result of this investigation was a dead certainty even before it was conducted. The authors initiating PAC guided therapy 18 hours after the critically ill patients were admitted to intensive care units. This delay in the deployment of the PAC makes it extremely unlikely that PAC guided therapy would influence the mortality rate; it is like shutting the stable door after the horse has bolted. This study does not inform on the timely use of the pulmonary artery catheter.

The primary sample size calculation stipulated that 5673 patients were needed to demonstrate a 5% reduction in mortality. Due to slow recruitment, the primary endpoint was changed to a 10% reduction - 1281 patients were then required. In the end, the authors report the results from 1014 patients.

The principal clinical investigator/corresponding author M. Singer “does consultancy work for, and receives research funds from Deltex Medical, manufacturers of the CardioQ oesophageal Doppler device.”

Preben G. Berthelsen MD

Charlottenlund, Denmark