Journal Article

Pulmonary-Artery versus Central Venous Catheter to Guide Treatment of Acute Lung Injury

Bernard, Gordon R, Harabin, Andrea L, Connors, Jr, Alfred F, Wiedemann, Herbert P, deBoisblanc, Ben, Wheeler, Arthur P, Thompson, B Taylor, Hite, R Duncan, Schoenfeld, David

2006

Overview

Hemodynamic monitoring is a common physiological intervention in patients with acute lung injury. In this randomized, controlled trial in which patient care was dictated by a specific hemodynamic protocol, there was no significant difference in 60-day mortality whether monitoring was performed with a pulmonary-artery catheter or a central venous catheter. Hemodynamic monitoring is a common physiological intervention in patients with acute lung injury. In this trial there was no significant difference in 60-day mortality whether monitoring was performed with a pulmonary-artery catheter or a central venous catheter. The pulmonary-artery catheter (PAC) provides unique hemodynamic data, including the cardiac index and pulmonary-artery–occlusion pressure. People who advocate the use of the PAC note that the clinician's ability to predict intravascular pressure with the use of this catheter is poor 1 – 3 ; central venous pressure, as obtained by means of the PAC, correlates imperfectly with pulmonary-artery–occlusion pressure 4 – 6 ; and the insertion of a PAC often changes therapy. 6 – 8 Although many critically ill patients receive PACs, 9 no clear clinical benefit has been associated with their use. 10 – 12 Practitioners often misinterpret the information obtained by means of a PAC or act . . .

• Publisher: Massachusetts Medical Society
• Subject: Analysis of Variance / Arrhythmias, Cardiac - etiology / Biological and medical sciences / Blood Pressure / Catheterization, Central Venous - adverse effects / Catheterization, Swan-Ganz - adverse effects / Catheters / Clinical trials / Comorbidity / Female / Fluid Therapy / General aspects / Humans / Injuries / Kidney - physiology / Lungs / Male / Medical sciences / Medical treatment / Middle Aged / Pulmonary arteries / Pulmonary Artery - physiology / Respiration, Artificial / Respiratory Distress Syndrome, Adult - etiology / Respiratory Distress Syndrome, Adult - mortality / Respiratory Distress Syndrome, Adult - physiopathology / Respiratory Distress Syndrome, Adult - therapy / Respiratory Physiological Phenomena / Survival Analysis / Treatment Outcome / Water-Electrolyte Balance