Pulmonary artery catheter.

Since its inception, the pulmonary artery catheter has enjoyed widespread use in both medical and surgical critically ill patients. It has also endured criticism and skepticism about its benefit in these patient populations. By providing information such as cardiac output, mixed venous oxygen saturation, and intracardiac pressures, the pulmonary artery catheter may improve care of the most complex critically ill patients in the intensive care unit and the operating room. With its ability to transduce pressures through multiple ports, one of the primary clinical uses for pulmonary artery catheters is real-time intracardiac pressure monitoring. Correct interpretation of the waveforms is essential to confirming correct placement of the catheter to ensure accurate data are recorded. Major complications related to catheter placement are infrequent, but misinterpretation of monitored data is not uncommon and has led many to question the utility of the pulmonary artery catheter. The evidence to date suggests that the use of the catheter does not change mortality in many critically ill patients and may expose these patients to a higher rate of complications. However, additional clinical trials are needed, particularly in the most complex critically ill patients, who have generally been excluded from many of the research trials performed to date.

Duke Scholars

Author Jonathan Ball Mark Anesthesiology, VA Anesthesiology Service