International anesthesiology clinics
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Int Anesthesiol Clin · Jan 1993
ReviewClinical utilization of pulmonary artery catheter monitoring.
Since the introduction of PA catheter monitoring in 1970, the applications for it have dramatically broadened. PA catheters are used to obtain hemodynamic data for the assessment, monitoring, and therapeutic management of critically ill, high-risk surgical patients. Because of potential complications associated with PA catheter monitoring, numerous editorials and articles have questioned the procedure's risk-to-benefit ratio. ⋯ Problems may stem not from technology but from the knowledge and expectations of clinicians. "Human" complications from inadequate understanding of the physiological data is not uncommon. Measured pressures by themselves can be misleading; indeed use of absolute numbers rather than trends or relative changes in the values monitored can compromise clinical assessment. Overzealous acceptance and utilization of any quantitative measurement without sound clinical judgment is fraught with failure.
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Mechanical ventilation in the ICU provides oxygenation, ventilation, and decreased work of breathing for patients with respiratory failure. Prior to the 1970s, the ventilator functioned independently of the patient. ⋯ These and the use of gas permeable membranes have added significant new dimensions to respiratory care in the ICU. The ultimate goal is to utilize our expanding knowledge base and improved technology to decrease morbidity and mortality due to respiratory failure.