Pulmonary artery catheterization has not demonstrated outcome benefits to critically ill patients in multiple well-conducted clinical studies, despite its routine use for hemodynamic monitoring.
Does pulmonary artery catheterization improve outcomes in critically ill patients?
Despite providing detailed hemodynamic data, pulmonary artery catheterization has not been shown to improve clinical outcomes in critically ill patients.
Pulmonary artery catheterization has been a routine part of care for critically ill patients over the past 25 years. Primary hemodynamic data regarding cardiac output and pulmonary pressures can be utilized to make diagnoses and guide therapy. Tissue oxygen delivery and utilization allow inferences about the efficiency of the cardiopulmonary system and the impact of disease and medical therapies on tissue metabolism. Goals of high level invasive monitoring of cardiopulmonary function with pulmonary artery catheterization are organ salvage and minimizing complications associated with critical illness. Optimizing renal perfusion and minimizing pulmonary congestion with precise volume titration are common reasons for performing pulmonary artery catheterization in the intensive care unit. Despite being reassuring to clinicians that hemodynamic therapy is optimal, multiple data from well conducted clinical studies have not demonstrated outcome benefits to patients related to pulmonary artery catheterization. Less invasive techniques to obtain data regarding hemodynamic function are now entering the clinical arena and are being actively investigated.
McGee et al. (Wed,) conducted a review in Critical illness. Pulmonary artery catheterization was evaluated. Pulmonary artery catheterization has not demonstrated outcome benefits to critically ill patients in multiple well-conducted clinical studies, despite its routine use for hemodynamic monitoring.