History of right heart catheterization: 100 years of experimentation and methodology development.
The development of right heart catheterization has provided the clinician the ability to diagnose patients with congenital and acquired right heart disease, and to monitor patients in the intensive care unit with significant cardiovascular illnesses. The development of bedside pulmonary artery catheterization has become a standard of care for the critically ill patient since its introduction into the intensive care unit almost 40 years ago. However, adoption of this procedure into the mainstream of clinical practice occurred without prior evaluation or demonstration of its clinical or cost-effectiveness. Moreover, current randomized, controlled trials provide little evidence in support of the clinical utility of pulmonary artery catheterization in the management of critically ill patients. Nevertheless, the right heart catheter is an important diagnostic tool to assist the clinician in the diagnosis of congenital heart disease and acquired right heart disease, and moreover, when catheter placement is proximal to the right auricle (atria), this catheter provides an important and safe route for administration of fluids, medications, and parenteral nutrition. The purpose of this manuscript is to review the development of right heart catheterization that led to the ability to conduct physiologic studies in cardiovascular dynamics in normal individuals and in patients with cardiovascular diseases, and to review current controversies of the extension of the right heart catheter, the pulmonary artery catheter.
Nossaman
Bobby D
BD
Department of Anesthesiology, Critical Care Medicine Section, Ochsner Medical Center, New Orleans, Louisiana, USA.
Scruggs
Brittni A
BA
Nossaman
Vaughn E
VE
Murthy
Subramanyam N
SN
Kadowitz
Philip J
PJ
D000818:Animals; D035843:Biomedical Research / Q000266:history; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000266:history; D002320:Cardiovascular Physiological Phenomena; D002407:Catheterization, Swan-Ganz / Q000266:history* / Q000295:instrumentation / Q000379:methods; D006439:Hemodynamics; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007362:Intensive Care Units / Q000266:history