Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients

P. R. Eisenberg, Allan S Jaffe, D. P. Schuster

Research output: Contribution to journalArticle

281 Citations (Scopus)

Abstract

Although pulmonary artery (PA) catheterization is frequently employed in the management of critically ill patients, there is little documentation that the information obtained alters patient management. This study evaluated prospectively this question in 103 PA catheterizations. Before catheterization, physicians were asked to predict the range of several hemodynamic variables, the presumed diagnosis, and their plan for therapy. After catheterization, each chart was reviewed. The hemodynamics at the time of catheterization and therapy within 8 h of catheterization were noted. Pulmonary artery occlusive (wedge) pressure (WP) was correctly predicted 30% of the time. Cardiac output, systemic vascular resistance (SVR), and right atrial pressure (RAP) were correctly predicted approximately 50% of the time. There was no significant difference in the ability to predict hemodynamics of subgroups with either hypotension or impaired oxygenation. After catheterization, planned therapy was altered in 58% of the cases. Unanticipated therapy was added in 30% of the cases. This study documents the difficulty of predicting accurately hemodynamics based solely on clinical evaluation. Thus, the information obtained by catheterization often leads to alterations in the therapeutic plan. We suggest that PA catheterization is both indicated and useful in the management of critically ill patients.

Original languageEnglish (US)
Pages (from-to)549-553
Number of pages5
JournalCritical Care Medicine
Volume12
Issue number7
StatePublished - 1984
Externally publishedYes

Fingerprint

Swan-Ganz Catheterization
Critical Illness
Catheterization
Hemodynamics
Therapeutics
Pulmonary Wedge Pressure
Atrial Pressure
Documentation
Cardiac Output
Vascular Resistance
Hypotension
Physicians

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients. / Eisenberg, P. R.; Jaffe, Allan S; Schuster, D. P.

In: Critical Care Medicine, Vol. 12, No. 7, 1984, p. 549-553.

Research output: Contribution to journalArticle

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