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Pulmonary Artery Catheterization and Its Problems

  • Rajinder K. Chitkara
  • Gregory V. Serio

Abstract

During the past 20 years significant advances have been made in the care of the critically ill patient. The introduction of the flow-directed, balloon-tipped (Swan-Ganz) pulmonary artery catheter is among the notable advances in the care of such patients.1 Although pulmonary artery catheterization has now become an integral procedure in the diagnosis and management of these patients, in recent years there has been growing concern about their overuse. In one study of 142 consecutive autopsies, 38% (55 patients) of the patients had undergone catheterization before death.2 These data suggest an exponential increase in the use of pulmonary artery catheters. Pulmonary artery catheterization provides considerable physiologic data, which gives the treating physician a better understanding of the pathophysiology of the patient’s illness and thus a more rational basis for therapy.3 This approach, however, has not proven to result in any significant improvement in the overall outcome.4 Moreover, the risk-benefit ratio of this catheter has not been established in the myriad of clinical situations where it has been used. However, it is important to realize that the risk of complications is substantial, and there is sufficient data to suggest a high morbidity as well as mortality associated with its use.2,5–7 Thus, there exists a growing awareness that a careful evaluation for the risk versus benefit must be applied for each patient who receives a pulmonary artery catheter. The purpose of this review is to identify those patients who are most likely to benefit from pulmonary artery catheterization, to outline the risks associated with the procedure, and to discuss the anticipated legal problems that may arise from indiscriminate use of the catheter.

Keywords

Cardiac Output Pulmonary Artery Infective Endocarditis Pulmonary Artery Catheterization Adult Respiratory Distress Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag New York Inc. 1989

Authors and Affiliations

  • Rajinder K. Chitkara
  • Gregory V. Serio

There are no affiliations available

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