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Let us use the pulmonary artery catheter correctly and only when we need it

Pinsky, MR and Vincent, JL (2005) Let us use the pulmonary artery catheter correctly and only when we need it. Critical Care Medicine, 33 (5). 1119 - 1122. ISSN 0090-3493

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Abstract

Objective: To clarify the issues related to the use of the pulmonary artery catheter within a rational clinical perspective. Results: Barriers include a) increased patient risk of pulmonary artery catheter placement; b) ability to measure similar variables via central venous catheterization, echocardiography, or other less invasive techniques; c) increased cost; d) inaccurate measurements; e) incorrect interpretation and application of pulmonary artery catheter-derived variables; and f) lack of proven benefit of pulmonary artery catheter use in the overall management of patients. Interpretation: a) The risks are mainly due to insertion of a central catheter, not a pulmonary artery catheter; b) continuous monitoring of left ventricular filling pressures, pulmonary vascular pressures, and mixed venous oxygen saturation is a unique feature; c) additional costs are minimal relative to the cost of intensive care; d) measurement errors require ongoing programmatic educational efforts; e) pulmonary artery catheter-derived data need to be used within the context of a defined treatment protocol; and f) no monitoring device, no matter how simple or sophisticated, will improve patient-centered outcomes unless coupled with a treatment that, itself, improves outcome. Conclusion: A treatment protocol for the use of pulmonary artery catheter-derived variables is proposed that could serve as a basis for a prospective clinical trial. Copyright © 2005 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Pinsky, MRpinsky@pitt.eduPINSKY
Vincent, JL
Date: 1 May 2005
Date Type: Publication
Journal or Publication Title: Critical Care Medicine
Volume: 33
Number: 5
Page Range: 1119 - 1122
DOI or Unique Handle: 10.1097/01.ccm.0000163238.64905.56
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0090-3493
Article Type: Review
PubMed ID: 15891346
Date Deposited: 05 Apr 2012 21:56
Last Modified: 04 Feb 2019 15:57
URI: http://d-scholarship.pitt.edu/id/eprint/11580

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