Abstract
After its initial description by Swan and Ganz more than 30 years ago (1), the pulmonary artery catheter (PAC) technique rapidly became more and more popular in the following years. To date, the PAC remains the monitoring tool that enables more extensive hemodynamic assessment of the critically ill. Furthermore, its use has stimulated the comprehension of physiologic concepts of hemodynamics and tissue oxygenation in various situations of acute circulatory failure. After years of debate about its adverse effects, recent largescale studies clearly demonstrate that the use of the PAC does not alter the outcome of critically ill patients.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Swan HJ, Ganz W, Forrester J, et al. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med 1970;283:447–51.
Mihm FG, Gettinger A, Hanson CW, 3rd, et al. A multicenter evaluation of a new continuous cardiac output pulmonary artery catheter system. Crit Care Med 1998;26:1346–50.
Burchell SA, Yu M, Takiguchi SA, Ohta RM, et al. Evaluation of a continuous cardiac output and mixed venous oxygen saturation catheter in critically ill surgical patients. Crit Care Med 1997;25:388–91.
Birman H, Haq A, Hew E, Aberman A. Continuous monitoring of mixed venous oxygen saturation in hemodynamically unstable patients. Chest 1984;86:753–6.
Martin C, Auffray JP, Saux P, et al. The axillary vein: an alternative approach for percutaneous pulmonary artery catheterization. Chest 1986;90:694–7.
Leibowitz AB, Halpern NA, Lee MH, et al. Left-sided superior vena cava: a not-so-unusual vascular anomaly discovered during central venous and pulmonary artery catheterization. Crit Care Med 1992;20:1119–22.
Hanson EW, Hannan RL, Baum VC. Pulmonary artery catheter in the coronary sinus: implications of a persistent left superior vena cava for retrograde cardioplegia. J Cardiothorac Vasc Anesth 1998;12:448–9.
Stetz CW, Miller RG, Kelly GE, et al. Reliability of the thermodilution method in the determination of cardiac output in clinical practice. Am Rev Respir Dis 1982;126:1001–4.
Boldt J, Menges T, Wollbruck M, et al. Is continuous cardiac output measurement using thermodilution reliable in the critically ill patient? Crit Care Med 1994;22:1913–8.
Jacquet L, Hanique G, Glorieux D, et al. Analysis of the accuracy of continuous thermodilution cardiac output measurement. Comparison with intermittent thermodilution and Fick cardiac output measurement. Intensive Care Med 1996;22:1125–9.
Bottiger BW, Soder M, Rauch H, et al. Semi-continuous versus injectate cardiac output measurement in intensive care patients after cardiac surgery. Intensive Care Med 1996;22:312–8.
Dhingra VK, Fenwick JC, Walley KR, et al. Lack of agreement between thermodilution and Fick cardiac output in critically ill patients. Chest 2002;122:990–7.
Poli de Figueiredo LF, Malbouisson LM, Varicoda EY, et al. Thermal filament continuous thermodilution cardiac output delayed response limits its value during acute hemodynamic instability. J Trauma 1999;47:288–93.
Teboul JL, Zapol WM, Brun-Buisson C, et al. A comparison of pulmonary artery occlusion pressure and left ventricular end-diastolic pressure during mechanical ventilation with PEEP in patients with severe ARDS. Anesthesiology 1989;70:261–6.
Pinsky MR. Pulmonary artery occlusion pressure. Intensive Care Med 2003;29:19–22.
Teboul JL, Andrivet P, Ansquer M, et al. A bedside index assessing the reliability of pulmonary occlusion pressure during mechanical ventilation with positive end-expiratory pressure. J Crit Care 1992;7:22–9.
Teboul JL, Pinsky MR, Mercat A, et al. Estimating cardiac filling pressure in mechanically ventilated patients with hyperinflation. Crit Care Med 2000;28:3631–6.
Pinsky M, Vincent JL, De Smet JM. Estimating left ventricular filling pressure during positive endexpiratory pressure in humans. Am Rev Respir Dis 1991;143:25–31.
Raper R, Sibbald WJ. Misled by the wedge? The Swan-Ganz catheter and left ventricular preload. Chest 1986;89:427–34.
Kumar A, Anel R, Bunnell E, et al. Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects. Crit Care Med 2004;32:691–9.
Crexells C, Chatterjee K, Forrester JS, et al. Optimal level of filling pressure in the left side of the heart in acute myocardial infarction. N Engl J Med 1973;289:1263–6.
Nunes S, Ruokonen E, Takala J. Pulmonary capillary pressures during the acute respiratory distress syndrome. Intensive Care Med 2003;29:2174–9.
Teboul JL, Andrivet P, Ansquer M, et al. Bedside evaluation of the resistance of large and medium pulmonary veins in various lung diseases. J Appl Physiol 1992;72:998–1003.
Cope DK, Allison RC, Parmentier JL, et al. Measurement of effective pulmonary capillary pressure using the pressure profile after pulmonary artery occlusion. Crit Care Med 1986;14:16–22.
Pinsky MR. Clinical significance of pulmonary artery occlusion pressure. Intensive Care Med 2003;29:175–8.
Wiedemann HP. Wedge pressure in pulmonary veno-occlusive disease. N Engl J Med 1986;315:1233.
Teboul JL, Douguet D, Mercat A, et al. Effects of catecholamines on the pulmonary venous bed in sheep. Crit Care Med 1998;26:1569–75.
Bindels AJ, van der Hoeven JG, Meinders AE. Pulmonary artery wedge pressure and extravascular lung water in patients with acute cardiogenic pulmonary edema requiring mechanical ventilation. Am J Cardiol 1999;84:1158–63.
Ferguson ND, Meade MO, Hallett DC, et al. High values of the pulmonary artery wedge pressure in patients with acute lung injury and acute respiratory distress syndrome. Intensive Care Med 2002;28:1073–7.
Lemaire F, Teboul JL, Cinotti L, et al. Acute left ventricular dysfunction during unsuccessful weaning from mechanical ventilation. Anesthesiology 1988;69:171–9.
Monnet X, Teboul JL. Invasive measures of left ventricular preload. Curr Opin Crit Care 2006;12:235–40.
Michard F, Teboul JL. Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 2002;121:2000–8.
Vincent JL, Weil MH. Fluid challenge revisited. Crit Care Med 2006;34:1333–7.
The National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med 2006;354:2213–2224.
The National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Comparison of Two Fluid-Management Strategies in Acute Lung Injury. N Engl J Med 2006;354:2564–75.
Vincent JL, Thirion M, Brimioulle S, et al. Thermodilution measurement of right ventricular ejection fraction with a modified pulmonary artery catheter. Intensive Care Med 1986;12:33–8.
Spinale FG, Smith AC, Carabello BA, et al. Right ventricular function computed by thermodilution and ventriculography. A comparison of methods. J Thorac Cardiovasc Surg 1990;99:141–52.
Spinale FG, Mukherjee R, Tanaka R, et al. The effects of valvular regurgitation on thermodilution ejection fraction measurements. Chest 1992;101:723–31.
Hassan E, Roffman DS, Applefeld MM. The value of mixed venous oxygen saturation as a therapeutic indicator in the treatment of advanced congestive heart failure. Am Heart J 1987;113:743–9.
Richard C, Thuillez C, Pezzano M, et al. Relationship between mixed venous oxygen saturation and cardiac index in patients with chronic congestive heart failure. Chest 1989;95:1289–94.
Teboul JL, Annane D, Thuillez C, et al. Effects of cardiovascular drugs on oxygen consumption/oxygen delivery relationship in patients with congestive heart failure. Chest 1992;101:1582–7.
Teboul JL, Graini L, Boujdaria R, et al. Cardiac index vs oxygen-derived parameters for rational use of dobutamine in patients with congestive heart failure. Chest 1993;103:81–5.
Nunez S, Maisel A. Comparison between mixed venous oxygen saturation and thermodilution cardiac output in monitoring patients with severe heart failure treated with milrinone and dobutamine. Am Heart J 1998;135:383–8.
Gattinoni L, Brazzi L, Pelosi P, et al. A trial of goaloriented hemodynamic therapy in critically ill patients. SvO2 Collaborative Group. N Engl J Med 1995;333:1025–32.
Teboul JL, Mercat A, Lenique F, et al. Value of the venous-arterial PCO2 gradient to reflect the oxygen supply to demand in humans: effects of dobutamine. Crit Care Med 1998;26:1007–10.
Patel C, Laboy V, Venus B, et al. Acute complications of pulmonary artery catheter insertion in critically ill patients. Crit Care Med 1986;14:195–7.
Sprung CL, Pozen RG, Rozanski JJ, et al. Advanced ventricular arrhythmias during bedside pulmonary artery catheterization. Am J Med 1982;72:203–8.
Damen J. Ventricular arrhythmias during insertion and removal of pulmonary artery catheters. Chest 1985;88:190–3.
Davies MJ, Cronin KD, Domaingue CM. Pulmonary artery catheterisation. An assessment of risks and benefits in 220 surgical patients. Anaesth Intensive Care 1982;10:9–14.
Iberti TJ, Benjamin E, Gruppi L, et al. Ventricular arrhythmias during pulmonary artery catheterization in the intensive care unit. Prospective study. Am J Med 1985;78:451–4.
Mullerworth MH, Angelopoulos P, Couyant MA, et al. Recognition and management of catheterinduced pulmonary artery rupture. Ann Thorac Surg 1998;66:1242–5.
Tayoro J, Dequin PF, Delhommais A, et al. Rupture of pulmonary artery induced by Swan-Ganz catheter: success of coil embolization. Intensive Care Med 1997;23:198–200.
Ferretti GR, Thony F, Link KM, et al. False aneurysm of the pulmonary artery induced by a Swan-Ganz catheter: clinical presentation and radiologic management. Am J Roentgenol 1996;167:941–5.
Koh KF, Chen FG. The irremovable swan: a complication of the pulmonary artery catheter. J Cardiothorac Vasc Anesth 1998;12:561–2.
Bhatti WA, Sinha S, Rowlands P. Percutaneous untying of a knot in a retained Swan-Ganz catheter. Cardiovasc Intervent Radiol 2000;23:224–5.
Boyd KD, Thomas SJ, Gold J, Boyd AD. A prospective study of complications of pulmonary artery catheterizations in 500 consecutive patients. Chest 1983;84:245–9.
Richard C, Warszawski J, Anguel N, et al. Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA 2003;290:2713–20.
Ivanov R, Allen J, Calvin JE. The incidence of major morbidity in critically ill patients managed with pulmonary artery catheters: a meta-analysis. Crit Care Med 2000;28(3):615–9.
Shah KB, Rao TL, Laughlin S, et al. A review of pulmonary artery catheterization in 6,245 patients. Anesthesiology 1984;61:271–5.
Connors AF Jr, Speroff T, Dawson NV, et al. The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA 1996;276:889–97.
Binanay C, Califf RM, Hasselblad V, et al; ESCAPE Investigators and ESCAPE Study Coordinators. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA 2005;294:1625–33.
Bayram M, De Luca L, Massie MB, et al. Reassessment of dobutamine, dopamine, and milrinone in the management of acute heart failure syndromes. Am J Cardiol 2005;96:47G–58G.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer-Verlag London Limited
About this chapter
Cite this chapter
Monnet, X., Teboul, JL. (2008). Pulmonary Artery Catheter in the Intensive Care Unit. In: Mebazaa, A., Gheorghiade, M., Zannad, F.M., Parrillo, J.E. (eds) Acute Heart Failure. Springer, London. https://doi.org/10.1007/978-1-84628-782-4_38
Download citation
DOI: https://doi.org/10.1007/978-1-84628-782-4_38
Publisher Name: Springer, London
Print ISBN: 978-1-84628-781-7
Online ISBN: 978-1-84628-782-4
eBook Packages: MedicineMedicine (R0)