Document Detail

Bedside catheterization of the pulmonary artery: risks compared with benefits.
MedLine Citation:
PMID:  3056159     Owner:  NLM     Status:  MEDLINE    
The decision to use bedside pulmonary artery catheterization for managing patients must involve a careful assessment of the risks compared to the benefits. Complications can be minimized by following specific guidelines for catheter insertion and maintenance. Pulmonary artery catheterization has been shown to be more accurate than clinical assessment alone in critically ill patients for determining the cause of shock (hypovolemic, cardiogenic, or septic) or for assessing the cause of severe pulmonary edema (cardiogenic or noncardiogenic). The diagnosis of cardiac failure in medical or surgical patients with invasive hemodynamic monitoring provides physiologic data that guide pharmacologic treatment that may favorably influence preload and afterload in the failing or ischemic heart. Managing hemodynamics with the aid of pulmonary artery catheterization in patients with the adult respiratory distress syndrome has received considerable attention, but a contribution to better patient outcome has not been established. Similarly, although clinical management of hemodynamic instability in septic shock is facilitated by pulmonary artery catheterization, the mortality remains very high because of the lack of specific therapy to reverse the sepsis syndrome. Adequate volume resuscitation and improved tissue oxygenation are universally accepted goals, but specific hemodynamic endpoints are controversial and direct measurements of tissue oxygenation are not possible. Prospective studies to define the clinical value of pulmonary artery catheterization are needed, but must be designed very carefully in order to identify unequivocally the effect of pulmonary artery catheterization on outcome in critically ill patients.
M A Matthay; K Chatterjee
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Annals of internal medicine     Volume:  109     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1988 Nov 
Date Detail:
Created Date:  1988-12-05     Completed Date:  1988-12-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  826-34     Citation Subset:  AIM; IM    
University of California, San Francisco.
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MeSH Terms
Catheterization, Swan-Ganz / adverse effects,  methods*
Heart Failure / physiopathology
Monitoring, Physiologic / instrumentation
Myocardial Infarction / physiopathology
Outcome and Process Assessment (Health Care)
Pulmonary Artery*
Pulmonary Edema / physiopathology
Shock, Septic / physiopathology
Surgical Procedures, Operative
Grant Support

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