Key result
Routine use of pulmonary artery catheters to adjust therapy during hospitalization for decompensation of chronic heart failure had no significant impact on morbidity or mortality.
Why the study?
Does the use of pulmonary artery catheters improve outcomes in patients with advanced heart failure?
Does the use of pulmonary artery catheters improve outcomes in patients with advanced heart failure?
Routine use of pulmonary artery catheters is not indicated for adjusting therapy in decompensated chronic heart failure, though specific clinical situations may still warrant its use.
Does not support routine pulmonary artery catheter use in decompensated HF; leaves open selective application and targeted trials.
PURPOSE OF REVIEW: Randomized trials have demonstrated that use of the pulmonary artery catheter does not improve outcomes in patients with critical illness. Despite this, pulmonary artery catheters continue to be used, especially in heart failure. This review addresses recent clinical trials evaluating the safety and efficacy of the pulmonary artery catheter. It also offers guidelines on when pulmonary artery catheter use could be considered in patients with advanced heart failure. RECENT FINDINGS: A meta-analysis demonstrated that use of the pulmonary artery catheter in critically ill patients had no significant impact on morbidity or mortality. In the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial, the addition of the pulmonary artery catheter to careful clinical assessment also had neutral impact. The results of the study are limited, however, by the patient population that was selected for the study, and there still may be a role for the pulmonary artery catheter in advanced heart failure. SUMMARY: Based on the results of the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial and the meta-analysis, there is no indication for routine use of pulmonary artery catheters to adjust therapy during hospitalization for decompensation of chronic heart failure. There remain many specific clinical situations in heart failure in which the pulmonary artery catheter may be useful, however.
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Shah et al. (2007) conducted a review in Advanced heart failure. Pulmonary artery catheter vs. Careful clinical assessment was evaluated on Morbidity or mortality. Routine use of pulmonary artery catheters to adjust therapy during hospitalization for decompensation of chronic heart failure had no significant impact on morbidity or mortality.
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