Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA.
Pediatr Crit Care Med. 2011 Jul;12(4 Suppl):S12-20. doi: 10.1097/PCC.0b013e318220f079.
After its introduction in 1970, the use of the pulmonary artery catheter became a central part of the management of critically ill patients in adult and pediatric intensive care units. However, because it was introduced as a class II device, efficacy for its safety and clinical benefit did not exist during the early years of use. This review describes the pulmonary artery catheter and reviews the literature supporting its use.
A search of MEDLINE, PubMed, and the Cochrane Database was made to find literature about pulmonary artery catheter use. Literature for both adult and pediatric patients was reviewed. Guidelines published by the Society for Critical Care Medicine and the American Heart Association were reviewed, including further review of references cited.
The evidence supporting the use of the pulmonary artery catheter is mostly limited to level IV (nonrandomized, historical controls, and expert opinion) and level V (case series, uncontrolled studies, and expert opinion). A higher level of evidence supports the use of the pulmonary artery catheter in selected pediatric patients, especially those with pulmonary arterial hypertension and shock refractory to standard fluid resuscitation and vasoactive agents. There are no data to suggest that use of the pulmonary artery catheter increases mortality in children.
自 1970 年推出以来，肺动脉导管的使用已成为成人和儿科重症监护病房危重病患者管理的核心部分。然而，由于它被引入为 II 类设备，在使用的早期，其安全性和临床效益的疗效并不存在。本综述描述了肺动脉导管，并回顾了支持其使用的文献。
对 MEDLINE、PubMed 和 Cochrane 数据库进行了搜索，以查找有关肺动脉导管使用的文献。对成人和儿科患者的文献进行了回顾。审查了危重病医学会和美国心脏协会发布的指南，包括进一步审查引用的参考文献。
支持肺动脉导管使用的证据主要限于 IV 级（非随机、历史对照和专家意见）和 V 级（病例系列、非对照研究和专家意见）。有更高证据水平支持在选定的儿科患者中使用肺动脉导管，尤其是那些患有肺动脉高压和对标准液体复苏和血管活性药物难治性休克的患者。没有数据表明肺动脉导管的使用会增加儿童的死亡率。
