02 Nov 08
The pulmonary artery catheter: In medio virtus.
By JL Vincent, M Pinsky, CL Sprung, M Levy, JJ Marini, D Payen, A Rhodes, J Takala
Crit Care Med 2008; 36:3093-3096
To clarify the role of the pulmonary artery catheter in the intensive care unit.
Data Sources
Recent and relevant literature from MEDLINE and authors’ personal databases.
Study Selection
Studies on pulmonary artery catheter use and use of other monitoring devices in critically ill patients.
Data Extraction
Based largely on clinical experience and assessment of the relevant published literature and in response to recent articles attacking the pulmonary artery catheter, we propose that the pulmonary artery catheter is still a valuable tool for the hemodynamic monitoring of patients with complex disease processes in whom the information obtained from the pulmonary artery catheter may influence management. We suggest that there is a need to revisit the basics of hemodynamic management and reassess the way in which the pulmonary artery catheter is used, applying three key principles: correct measurement, correct data interpretation, and correct application.
Conclusion
The pulmonary artery catheter is still a valuable tool for hemodynamic monitoring when used in selected patients and by physicians adequately trained to correctly interpret and apply the data provided.