肺动脉导管在心衰的诊断和治疗中的作用。

Role of the pulmonary artery catheter in diagnosis and management of heart failure.

机构信息

Department of Cardiovascular Medicine, The Ohio State University, Davis Heart/Lung Research Institute, Columbus, OH 03210, USA.

出版信息

Cardiol Clin. 2011 May;29(2):281-8. doi: 10.1016/j.ccl.2011.03.001.

DOI:10.1016/j.ccl.2011.03.001

PMID:21459249

Abstract

The pulmonary artery catheter will likely earn a place in the history of medicine as one of the most useful tools that shaped our understanding and management of various diseases. An intense assessment of its application in nonacute and nonshock decompensated heart failure has been provided by the ESCAPE trial, a landmark investigation that showed an overall neutral impact of pulmonary artery catheter-guided therapy over therapy guided by clinical evaluation and judgment alone. The current guidelines reserve the use of a pulmonary artery catheter for the management of refractory heart failure and select conditions. The pulmonary artery catheter remains a useful instrument in clinical situations when clinical and laboratory assessment alone is insufficient in establishing the diagnosis and pathophysiologic condition, and in guiding effective, safe therapy.

摘要

肺动脉导管可能会作为医学史上最有用的工具之一而被载入史册，它帮助我们深入了解并改善了各种疾病的治疗效果。ESCAPE 试验对肺动脉导管在非急性和非休克性心力衰竭失代偿中的应用进行了深入评估，该试验是一项具有里程碑意义的研究，结果表明肺动脉导管指导治疗与仅基于临床评估和判断的治疗相比，总体上没有影响。目前的指南将肺动脉导管的使用保留在难治性心力衰竭和选择条件的管理中。在临床情况下，当仅通过临床和实验室评估不足以确定诊断和病理生理状况，以及指导有效和安全的治疗时，肺动脉导管仍然是一种有用的工具。