AP-HP, Service de réanimation médicale, Hôpital de Bicêtre and Faculté de médecine Paris-Sud, Univ Paris-Sud, EA 4046, Le Kremlin-Bicêtre, Paris, France.
Curr Opin Crit Care. 2011 Jun;17(3):296-302. doi: 10.1097/MCC.0b013e3283466b85.
Hemodynamic monitoring has gained widespread acceptance in intensive care units. Despite ongoing debate regarding its safety and efficacy, monitoring with the pulmonary artery catheter (PAC) remains used for the management of severe heart failure and shock.
To reanalyze using the most recently published literature in the field, the role of the PAC to manage critically ill patients with right ventricular failure, pulmonary hypertension and weaning failure from cardiac origin. The role of PAC as a gold standard to validate new cardiac output monitoring devices was also reported.
Despite competition with less invasive hemodynamic monitoring devices or ultrasonic methods, the PAC remains a useful monitoring device in situations in which the knowledge of pulmonary artery pressure, pulmonary artery occlusion pressure and oxygenation parameters are needed. The proper use of PAC requires, however, a perfect knowledge of the numerous pitfalls and difficulties in interpretation of its measurements.
血流动力学监测在重症监护病房中得到了广泛的认可。尽管关于其安全性和有效性的争论仍在继续,但肺动脉导管(PAC)监测仍被用于严重心力衰竭和休克的治疗。
使用该领域最新发表的文献重新分析,PAC 在管理右心衰竭、肺动脉高压和心脏来源的撤机失败的危重病患者中的作用。PAC 作为验证新心输出量监测设备的金标准的作用也有报道。
尽管面临着与微创血流动力学监测设备或超声方法的竞争,但在需要了解肺动脉压、肺动脉闭塞压和氧合参数的情况下,PAC 仍然是一种有用的监测设备。然而,PAC 的正确使用需要对其测量结果的众多陷阱和解释困难有充分的了解。