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Heart catheters do not benefit patients
November 03, 2006Doctors should probably stop using pulmonary artery catheters because they do not benefit patients, say doctors from Australia in this week's BMJ.
The pulmonary artery catheter was invented in 1968. It enabled bedside monitoring in critically ill patients by measuring heart output and capillary pressure in the lungs and became widely used in intensive care units.
But reports of serious complications soon appeared and arguments for and against its use have continued ever since.
The most recent evaluation, commissioned by the NHS Health Technology Assessment (HTA) programme, found that pulmonary artery catheters do not benefit patients and concluded that withdrawing them from UK intensive care units would be cost effective.
Another recent trial in patients with acute lung injury confirmed these findings, while an analysis of 13 trials reported no overall effect of using these devices on mortality or length of hospital stay.
So what should clinicians do with all this information?
Given that the use of pulmonary artery catheters increases the risk of important complications, continued use of these devices is difficult to defend, say the authors.
The onus is now on the proponents of the pulmonary artery catheter and related devices to limit their use to clinical trials and to show that protocols based on such devices do benefit patients, they conclude.
Heart catheters
The most recent evaluation, commissioned by the NHS Health Technology Assessment (HTA) programme, found that pulmonary artery catheters do not benefit patients and concluded that withdrawing them from UK intensive care units would be cost effective.
Another recent trial in patients with acute lung injury confirmed these findings, while an analysis of 13 trials reported no overall effect of using these devices on mortality or length of hospital stay.
So what should clinicians do with all this information?
Given that the use of pulmonary artery catheters increases the risk of important complications, continued use of these devices is difficult to defend, say the authors.
The onus is now on the proponents of the pulmonary artery catheter and related devices to limit their use to clinical trials and to show that protocols based on such devices do benefit patients, they conclude.
Heart catheters
Use of pulmonary artery catheter decreases substantially in US
Use of the pulmonary artery catheter decreased by 65 percent in the U.S. between 1993 and 2004, possibly due to growing evidence that this invasive procedure does not reduce the risk of death for hospitalized patients.
For patients with severe lung injury, less is more
Results from the largest controlled clinical trial of fluid management methods in patients with severe lung injury provide important new information on the risks and benefits of patient care strategies currently used in the intensive care unit.
Steroids do not prolong survival in intensive care patients with ARDS on life support
Corticosteroids do not improve survival in patients with late-stage acute respiratory distress syndrome (ARDS), according to new results from the ARDS Clinical Research Network of the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
Pulmonary artery catheter use neutral for patient outcomes
The use of a pulmonary artery catheter (PAC) - a device used for more than 30 years to assess cardiovascular health and to help guide the treatment of critically ill patients - does not appear to improve outcomes nor confer added risks to patients.
Blood flow monitoring system to reduce risks during heart surgery
A unique haemodynamic (blood flow) monitoring system which will help to minimise the risk of complications during cardiovascular surgery is being developed by Leeds-based medical devices company, Medics Research Ltd.
More Pulmonary Artery Catheter Current Events and Pulmonary Artery Catheter News Articles
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The Pulmonary Artery Catheter In Critical Care: A Concise Handbook by C. Perret (Author), D. Tagan (Author), F. Feihl (Author), JJ Marini (Author) Institute of Clinical Pathophysiology, Switzerland. Guide to the safe and effective use of the Swan-Ganz catheter in pulmonary artery catheterization. Covers theoretical, technical, and practical information. Includes case studies. For intensive care unit medical staff and nurses. | |
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Central Venous Catheter Complications - Reduce the Incidence of Complications from CVCs and Pulmonary Artery Catheters [3 VHS Video Cassettes and Guide) Also With: FDA (Producer) This videotape series was developed to help reduce the incidence of technique-related complications associated with the use of central venous catheters (CVCs) and pulmonary artery catheters. These videos are intended for all departments and clinics that use CVCs. The videos present and discuss different types of catheters, and demonstrate some of the most frequent and serious CVC complications. The techniques shown provide viewers with ideas and insights they may apply to their own clinical practice to increase safety in the use of these devices. Morbidity associated with CVC use is at least 10 percent. The predominant cause of complications is related to practitioner technique. Such complications include cardiac perforation, venous wall erosion, arterial perforation, thrombogenesis, air... |
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Pulmonary Artery Catheter: Methodology and Clinical Applications by Charles L. Sprung (Author) | |
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The Pulmonary artery catheter: Methodology & clinical applications by Critical Care Research Associates (Publisher) | |
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Memory Bank for Hemodynamic Monitoring: The Pulmonary Artery Catheter (The Jones and Bartlett Memory Bank) by Gary W. Ervin (Author), Sylvia Long (Author) Kaiser Foundation Hospital Medical Center, Hollywood, California. The Jones and Bartlett Pocket-Sized Nursing Reference Series. New edition of a pocket-sized quick-reference guide for critical care nurses. Wire spiral binding. EKG tracings. | |
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The reliability of the activated partial thromboplastin time drawn through monitoring lines by Teresa Heise Halloran (Author) |
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