New horizons (Baltimore, Md.)
-
To review the literature addressing the use of the pulmonary artery catheter (PAC) in patients with cardiovascular disease. ⋯ Pulmonary artery catheterization is often used to optimize patient management, although this may not be demonstrable in terms of prospective trials using mortality or other "hard" outcome measures. Nonetheless, more rapid diagnosis and achievement of therapeutic endpoints guided by PAC use can decrease morbidity and intensive care days.
-
To review the literature addressing use of the pulmonary artery catheter (PAC) in pediatric patients. ⋯ Until there is substantive evidence in children that outcome is negatively affected by their use, PACs should remain available. Experienced physicians should directly supervise PAC insertion and use.
-
To review the literature addressing economic issues related to use of the pulmonary artery catheter (PAC). ⋯ Widespread use of the PAC has significant economic ramifications. Data regarding cost-effectiveness of the PAC is extremely limited in terms of methodology and scope. Economic impact and cost-effectiveness are moot prior to establishing clinical efficacy.
-
To review the literature addressing the issue of a U.S. Food and Drug Administration (FDA) moratorium on use of the pulmonary artery catheter (PAC). ⋯ An FDA moratorium on the use of the PAC is not indicated.
-
To review the literature addressing the use of the pulmonary artery catheter (PAC) in patients with respiratory failure. ⋯ The optimal role of the PAC as a diagnostic and monitoring device in different types of respiratory failure has not been clearly defined. Research is needed to determine the role of the PAC in very carefully defined groups of patients with respiratory failure.