This survey demonstrates a significant shift in UK intensive care units away from pulmonary artery catheters towards less invasive cardiac output monitoring techniques.
Survey data reflect evolving UK ICU preferences; leaves open comparative outcome effects and need for prospective trials.
The current practice of cardiac output monitoring in critically ill patients was surveyed in 226 adult intensive care units in England and Wales. The response rate was 76% (n=171). Among the responding units, 96% used cardiac output monitoring routinely and 60% had access to more than one monitoring technique. Pulmonary artery catheters were no longer used in one third of the units. More than half of the units (57%) had moved to less invasive techniques. Oesophageal Doppler was used by 35% of the responding units, Lithium indicator Dilution Cardiac Output (LiDCO) by 22% and Pulse-induced Contour Cardiac Output (PiCCO) in 20%. Sixty-one percent of the lead clinicians felt that cardiac output monitoring may alter patient outcome. Two-thirds of units (68%) use superior vena cava oxygen saturation (ScvO 2 ) during initial resuscitation of patients with severe sepsis or septic shock.
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Labib et al. (2010) studied this question.
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