This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Colombo, J. A. Articles by Tuman, K. J. Search for Related Content PubMed Articles by Colombo, J. A. Articles by Tuman, K. J. Social Bookmarking                         What's this?

The Role of Pulmonary Artery Catheterization in the Management of Cardiothoracic Surgical Patients

Department of Anesthesiology, Rush Medical College at Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL

Kenneth J. Tuman

Department of Anesthesiology, Rush Medical College at Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL

Pulmonary artery catheterization (PAC) is a commonly used method for assessment of perfusion in critically ill patients, especially cardiothoracic surgical patients. A vast amount of clinical experience indicates that PAC provides clinicians with information about the cardiovas cular system that is otherwise not readily available at the bedside. This information is then used for the diagnosis of various hemodynamic abnormalities and subsequently to guide and judge the efficacy of thera peutic interventions. A number of small, but highly controlled, studies have suggested that outcome can be improved when data from PAC are used to guide therapy in a specific manner. Studies that have not defined specific treatment endpoints based on findings derived from PAC have failed to demonstrate outcome differences, especially when relatively small numbers of low-risk patients have been studied. A large number of other factors have precluded formal scientific validation of definitive outcome differences with PAC, and, until data are available from appropriately designed, ad equately powered trials without randomization break down, rigorous analysis of available data does not justify any immediate change in the use of PAC. Hemo dynamic monitoring with PAC remains an important aspect of care during and especially after major cardio vascular surgery, and selective use in high-risk patients appears to be the most prudent and cost-effective application of this technology.

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 2, No. 1, 46-51 (1998)
DOI: 10.1177/108925329800200104


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?