[HSF] Pulmonary Artery Catheters !

[nand kejriwal]

We too use them selectively in high risk cases. TOE is used routinely, so
that gives good info about LV contractility, filling etc. If a patient who
did not have a swan, needs inotropes in ICU, PICCO is used.

nand

On 11/4/06, Dr Patricio Villanueva <pfvil at intramed.net> wrote:
>
> We use them selectively, more common in a valvular surgery or patient with
> bad ventricular function to appropiate use of drugs.
>
> Patricio
> ----- Original Message -----
> From: "Nasser F. Abou'Seada" <nfaabouseada at gmail.com>
> To: <OpenHeart-L at lists.hsforum.com>
> Sent: Friday, November 03, 2006 7:30 AM
> Subject: RE: [HSF] Pulmonary Artery Catheters !
>
>
> How frequently do members of the forum use PA Catheter ?
> - Comments ??
>
> NFA
>
> HEART CATHETERS DO NOT BENEFIT PATIENTS
>
> (Editorial: Pulmonary artery catheters)
> http://bmj.com/cgi/content/full/333/7575/930
>
>
>
> Doctors 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.
>
>
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