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The Pulmonary Artery (Swan-Ganz) Catheter: Evaluation of A Hemodynamic Monitoring Device in Critical Care Medicine

Published online by Cambridge University Press:  10 March 2009

Giuseppe Pagliarello
Giuseppe Pagliarello
Affiliation:
Ottawa Civic Hospital
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Abstract

The pulmonary artery catheter (PAC) is an invasive hemodynamic monitoring device that is used extensively in critical care units. This technological advance allows the critical care physician and nurse to closely monitor physiological functions at the bedside. There have been no formal evaluations of the impact of this device on patient care. Reviews and observational studies have yielded different conclusions regarding risks and benefits to patients. This has resulted in much editorial comment expressing divergent opinions on the value of the PAC, but there has been no scientific evidence to guide practice and no apparent effect on the use of these devices. The PAC and other medical monitoring devices must be evaluated with respect to their impact on patient care.

Type
Special Section: Industry and the Generation of Technology
Information
International Journal of Technology Assessment in Health Care , Volume 9 , Issue 2 , Spring 1993 , pp. 202 - 209
Copyright
Copyright © Cambridge University Press 1993

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References

REFERENCES

1.Boyd, K. D., Thomas, S. J., Gold, J., & Boyd, A. D.A prospective study of complications of pulmonary artery catheterizations in 500 consecutive patients. Chest, 1983, 84, 245–49.CrossRefGoogle ScholarPubMed
2.Connors, A. F., McCaffree, D. R., & Gray, B. A.Evaluation of right-heart catheterization in the critically ill patient without acute myocardial infarction. New England Journal of Medicine, 1983, 308, 263–67CrossRefGoogle ScholarPubMed
3.Dalen, J. E.Bedside hemodynamic monitoring. New England Journal of Medicine, 1979, 301, 1176–78.Google Scholar
4.Eisenberg, P. R., Jaffe, A. S., & Schuster, D. P.Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients. Critical Care Medicine, 1984, 12, 549–53.Google Scholar
5.Elliott, C. G., Zimmerman, G. A., & Clemmer, T. P.Complications of pulmonary artery catheterization in the care of critically ill patients: A prospective study. Chest, 1979, 76, 647–52.CrossRefGoogle ScholarPubMed
6.Fein, A. M., Goldberg, S. K., Walkenstein, M. D., et al. Is pulmonary artery catheterization necessary for the diagnosis of pulmonary edema? American Review of Respiratory Dis eases, 1984, 129, 1006–09.Google Scholar
7.Forrester, J. S., Diamond, G., Chatterjee, K., & Swan, H. J. C.Medical therapy of acute myocardial infarction by application of hemodynamic subsets (First of two parts). New England Journal of Medicine, 1976, 295, 1356–62.Google Scholar
8.Gore, J. M., Goldberg, R. J., Spokick, D. H., et al. A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. Chest, 1987, 92, 721–27.Google Scholar
9.Guyatt, G. H., Tugwell, P. X., Feeny, D. H., et al. The role of before-after studies of ther apeutic impact in the evaluation of diagnostic technologies. Journal of Chronic Diseases, 1986, 39, 295–304.Google Scholar
10.Moser, K. M., & Spragg, R. G.Use of the balloon-tipped pulmonary artery catheter in pulmonary disease. Annals of Internal Medicine, 1983, 98, 53–58.Google Scholar
11.Raper, R., & Sibbald, W. J.Misled by the wedge? The Swan-Ganz catheter and left ventricular preload. Chest, 1986, 89, 427–34.Google Scholar
12.Robin, E. D.The cult of the Swan-Ganz catheter: Overuse and abuse of pulmonary flow catheters. Annals of Internal Medicine, 1985, 103, 445–49.CrossRefGoogle ScholarPubMed
13.Robin, E. D.Death by pulmonary artery flow-directed catheter. Chest, 1987, 92, 727–31.Google Scholar
14.Robin, E. D.Defenders of the pulmonary artery catheter. Chest, 1988, 93, 1059–1066.CrossRefGoogle ScholarPubMed
15.Rowley, K. M., Clubb, K. S., Walker-Smith, G. J., & Cabin, H. S.Right-sided infective endocarditis as a consequence of flow-directed pulmonary artery catheterization: A clinicopathological study of 55 autopsied patients. New England Journal of Medicine, 1984, 311, 1152–1156.CrossRefGoogle ScholarPubMed
16.Shoemaker, W. C.Use and abuse of the balloon tip pulmonary artery (Swan-Ganz®) catheter: Are patients getting their money's worth? Critical Care Medicine, 1990, 18, 1294–96.Google Scholar
17.Shoemaker, W. C., Appel, P. L., Kram, H. B., et al. Prospective trial of supranormal values of survivors as therapeutic goals in high risk surgical patients. Chest, 1988, 94, 1176–86.CrossRefGoogle ScholarPubMed
18.Shoemaker, W. C., Kram, H. B., Appel, P. L., & Fleming, A. W.The efficacy of central venous and pulmonary artery catheters and therapy based upon them in reducing mortality and morbidity. Archives of Surgery, 1990, 125, 1332–38.Google Scholar
19.Sibbald, W. J., & Sprung, C. L.The pulmonary artery catheter: The debate continues. Chest, 1988, 94, 899–901.Google Scholar
20.Sise, M. J., Hollingsworth, P., Brimm, J. E., et al. Complications of the flow-directed pulmonary-artery catheter: A prospective analysis in 219 patients. Critical Care, 1981, 4, 315–18.Google Scholar
21.Spodick, D. H.Physiologic and prognostic implications of invasive monitoring: Under mined risk benefit ratios in patients with heart disease. American Journal of Cardiology, 1980, 46, 173–75.Google Scholar
22.Swan, H. J. C., & Ganz, W.Complications with flow-directed balloon-tipped catheters. Annals of Internal Medicine, 1979, 91, 494.CrossRefGoogle ScholarPubMed
23.Swan, H. J. C, Ganz, W., Forrester, J., et al. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. New England Journal of Medicine, 1970, 283, 447–51.Google Scholar
24.Tuman, J. J., McCarthy, R. J., Spiess, B. D., et al. Effect of pulmonary artery catheterization on outcome in patients undergoing coronary artery surgery. Anesthesiology, 1989,70, 199–206. CrossRefGoogle ScholarPubMed