Pulmonary artery catheter and fluid management in acute lung injury and the acute respiratory distress syndrome.
The PAC provides a wealth of information about circulatory and respiratory systems and intravascular fluid volume over time. Specifically, the PAC allows measurement of central venous and pulmonary arterial pressure, pulmonary artery occlusion pressure, mixed venous blood gases, and indicator-dilution cardiac output. Based on these quantitative date, systemic and pulmonary vascular resistance can be derived. The PAC is frequently used in patients with ALI and ARDS, both to confirm the diagnosis and to optimize hemodynamic management. In this article, we review the evidence on the use of the PAC in patients with ALI/ARDS, paying particular attention to the recently published fluid and catheter treatment trial by the ARDS Clinical Trials Network.
Heresi
Gustavo A
GA
Department of Pulmonary, Allergy and Critical Care Medicine, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Arroliga
Alejandro C
AC
Wiedemann
Herbert P
HP
Weidemann
Herbert P
HP
Matthay
Michael A
MA
D001826:Body Fluids / Q000502:physiology*; D002302:Cardiac Output; D002407:Catheterization, Swan-Ganz; D005440:Fluid Therapy / Q000295:instrumentation*; D006801:Humans; D011669:Pulmonary Wedge Pressure; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome