TY - JOUR
T1 - Potential impact of pulmonary artery catheter placement on short-term management decisions in the medical intensive care unit
AU - Coles, N. Anthony
AU - Hibberd, Mark
AU - Russell, Mary
AU - Love, Ted
AU - Ory, Daniel
AU - Field, Terry S.
AU - Dec, G. William
AU - Eagle, Kim A.
PY - 1993/10
Y1 - 1993/10
N2 - The purpose of this study was to examine the potential impact of pulmonary artery (PA) catheter placement on short-term management decisions in the medical intensive care unit (ICU). One hundred three patients were examined over an 18-month period. The predominant indications for PA-catheter placement included refractory congestive heart failure, airspace disease, uncertain cardiac filling pressures, or hypotension. In 58 (56%) of the 103 patients, management recommendations changed as a direct result of knowledge gained by PA catheter placement. These changes involved fluid therapy recommendations in 41 patients, vasopressor use in 17 patients, intravenous vasodilator use in 24 patients, and recommendations for the use of inotropic agents in 15 patients. Although 18 patients experienced early or late complications, major events were limited to a single pneumothorax requiring chest tube insertion and four episodes of bacteremia. No deaths were directly attributable to the catheter insertion. In critically ill patients in the medical intensive care unit, PA-catheter placement leads to changes in recommendations for management in a substantial portion of patients with little risk of life-threatening complications in those who receive such invasive monitoring.
AB - The purpose of this study was to examine the potential impact of pulmonary artery (PA) catheter placement on short-term management decisions in the medical intensive care unit (ICU). One hundred three patients were examined over an 18-month period. The predominant indications for PA-catheter placement included refractory congestive heart failure, airspace disease, uncertain cardiac filling pressures, or hypotension. In 58 (56%) of the 103 patients, management recommendations changed as a direct result of knowledge gained by PA catheter placement. These changes involved fluid therapy recommendations in 41 patients, vasopressor use in 17 patients, intravenous vasodilator use in 24 patients, and recommendations for the use of inotropic agents in 15 patients. Although 18 patients experienced early or late complications, major events were limited to a single pneumothorax requiring chest tube insertion and four episodes of bacteremia. No deaths were directly attributable to the catheter insertion. In critically ill patients in the medical intensive care unit, PA-catheter placement leads to changes in recommendations for management in a substantial portion of patients with little risk of life-threatening complications in those who receive such invasive monitoring.
UR - http://www.scopus.com/inward/record.url?scp=0027501613&partnerID=8YFLogxK
U2 - 10.1016/0002-8703(93)90693-4
DO - 10.1016/0002-8703(93)90693-4
M3 - Article
C2 - 8213436
AN - SCOPUS:0027501613
SN - 0002-8703
VL - 126
SP - 815
EP - 819
JO - American heart journal
JF - American heart journal
IS - 4
ER -