Role of the pulmonary artery catheter in diagnosis and management of heart failure.
The pulmonary artery catheter will likely earn a place in the history of medicine as one of the most useful tools that shaped our understanding and management of various diseases. An intense assessment of its application in nonacute and nonshock decompensated heart failure has been provided by the ESCAPE trial, a landmark investigation that showed an overall neutral impact of pulmonary artery catheter-guided therapy over therapy guided by clinical evaluation and judgment alone. The current guidelines reserve the use of a pulmonary artery catheter for the management of refractory heart failure and select conditions. The pulmonary artery catheter remains a useful instrument in clinical situations when clinical and laboratory assessment alone is insufficient in establishing the diagnosis and pathophysiologic condition, and in guiding effective, safe therapy.
Kahwash
Rami
R
Department of Cardiovascular Medicine, The Ohio State University, Davis Heart/Lung Research Institute, Columbus, OH 43210, USA. rami.kahwash@osumc.edu
Leier
Carl V
CV
Miller
Leslie
L
D009320:Atrial Natriuretic Factor / Q000097:blood; D002407:Catheterization, Swan-Ganz; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D007902:Length of Stay; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010101:Oxygen Consumption; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012042:Registries
D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor