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Critical Care
Published in: Critical Care 3/2006

01-06-2006 | Review

Clinical relevance of data from the pulmonary artery catheter

Authors: Emmanuel Robin, Marion Costecalde, Gilles Lebuffe, Benoît Vallet

Published in: Critical Care | Special Issue 3/2006

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Abstract

The usefulness of parameters measured using the pulmonary artery catheter has been challenged because no benefit in patient outcome has been observed in clinical trials. However, technological advances have been made, including continuous measurement of cardiac output (CO), mixed venous saturation (SvO2), and right ventricle end-diastolic volume (CEDV) have been made. Pulmonary artery occlusion pressure (PAOP), CEDV and right atrial pressure (RAP) are not good predictors of fluid load responsiveness except when very low. Despite this methodological limitation, variation of these parameters during fluid loading remains a good indicator of fluid challenge tolerance. Accuracy of continuous thermodilution and SvO2 measurement has been demonstrated in vitro and at bedside. A decrease in SvO2 is a global index of an inadequate oxygen delivery (DO2)/oxygen requirement relationship. In this setting, a therapeutic decision to improve determinants of SvO2 should be considered with the help of all other PAC parameters. Technological improvement transforms PAC in a real time integrated physiological device and allows one to observe the impact of therapeutic intervention. What we need now is a clinical trial with a PAC-guided treatment algorithm taking into account the above integrated PAC parameters.
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Metadata
Title
Clinical relevance of data from the pulmonary artery catheter
Authors
Emmanuel Robin
Marion Costecalde
Gilles Lebuffe
Benoît Vallet
Publication date
01-06-2006
Publisher
BioMed Central
Published in
Critical Care / Issue Special Issue 3/2006
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc4830

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