de Waal E E C, de Rossi L, Buhre W
Division of Intensive Care Medicine, Department of Anaesthesiology, University Medical Center Utrecht, GA 3508 Utrecht, The Netherlands.
Anaesthesist. 2006 Jun;55(6):713-28; quiz 729-30. doi: 10.1007/s00101-006-1037-0.
The indication for the use of the pulmonary artery catheter (PAC) in high-risk patients is still a matter of discussion. Observational studies suggested that the use of the PAC did not result in decreased mortality but may even lead to increased mortality and morbidity. Therefore, a number of randomized controlled trials have been performed throughout recent years in patients suffering from sepsis/ARDS, congestive heart failure, multi-organ failure and those undergoing high-risk non-cardiac surgery. The majority of recent randomized studies failed to demonstrate any benefit of the PAC with respect to mortality and morbidity. However, the use of the PAC was also regularly not associated with an increase in morbidity and/or mortality. This review gives an overview of measurement parameters obtained by the current generation of PACs, alternatives to the PAC and recent studies on the use of the PAC in clinical practice.
肺动脉导管(PAC)在高危患者中的使用指征仍存在争议。观察性研究表明,使用PAC并未降低死亡率,甚至可能导致死亡率和发病率升高。因此,近年来针对脓毒症/急性呼吸窘迫综合征(ARDS)、充血性心力衰竭、多器官功能衰竭患者以及接受高风险非心脏手术的患者开展了多项随机对照试验。近期的大多数随机研究未能证明PAC在死亡率和发病率方面有任何益处。然而,使用PAC通常也与发病率和/或死亡率的增加无关。本综述概述了当前一代PAC所获得的测量参数、PAC的替代方法以及PAC在临床实践中应用的近期研究。