[Pulmonary artery catheter--its utility and limitations].
In Japan, over 50 thousand pulmonary artery catheters (PAC) per year were used for hemodynamic monitoring system perioperatively since 1970s. PAC provides many quantitative circulatory data, such as pulmonary capillary wedge pressure, cardiac output and continuous mixed venous oxygen saturation. On the contrary, several studies pointed out the problems of PAC and advocated the limitations of perioperative PAC monitoring in 2000s. Many randomized controlled studies showed that the use of PAC did not decrease mortality. In addition, aggressive therapy using PAC increased morbidity and complications. Physicians should become proficient in PAC and in obtaining and interpreting information from PAC. It is also important to use PAC in proper patients. I have also discussed other monitoring systems, such as aortic wave form analysis and central venous oxygen saturation, which were less invasive compared with PAC. I think abundant training, correct education and strict management must be employed to increase the benefit of PAC.
Ohnishi
Yoshihiko
Y
Department of Anesthesiology, National Cardiovascular Center, Suita 565-8565.
D002302:Cardiac Output; D002407:Catheterization, Swan-Ganz; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic