Do pulmonary artery catheters improve patient outcome? No.
The PAC has allowed physicians to obtain information that was unavailable prior to its introduction into clinical medicine. There are numerous pitfalls, however, in obtaining and interpreting this information. Even if these pitfalls are avoided, changing therapy to the patient's benefit based on PAC data is not guaranteed. In addition, application of new technologies, particularly TEE, has led to the suspicion that PA catheterization may frequently yield an incorrect assessment of the patient. Can PA catheterization lead to an improved outcome in an individual patient? If the patient is chosen carefully, the catheter inserted successfully and safely, the data obtained meticulously and interpreted correctly, and this interpretation leads to a change in therapy to which the patient responds appropriately, then the patient will experience an improved outcome based on PAC use. Does this happen often enough in the millions of catheterizations that are performed each year to improve the outcome of the group significantly as a whole? Almost certainly not.
Leibowitz
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Department of Anesthesiology, Mount Sinai School of Medicine of the City University of New York, New York, USA.
D015982:Bias; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects / Q000592:standards*; D003422:Critical Care / Q000379:methods / Q000458:organization & administration; D006801:Humans; D008991:Monitoring, Physiologic; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D015203:Reproducibility of Results