Department of Anesthesia, Yale University School of Medicine, New Haven, Connecticut, USA.
Department of Anesthesia, Pain Management and Perioperative Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
Ann Card Anaesth. 2021 Jan-Mar;24(1):4-7. doi: 10.4103/aca.ACA_125_19.
Ever since its clinical introduction, the utilization of the pulmonary artery catheter (PAC) has been surrounded by multiple controversies, mostly related to imprecise clinical indications and the complications derived from its placement. Currently, one of the most important criticisms of the PAC is the ambiguity in the interpretation of its hemodynamic measurements and therefore, in the translation of this data into specific therapeutic interventions. The popularity of the PAC stems from the fact that it provides hemodynamic data that cannot be obtained from clinical examination. The assumption is that this information would allow better understanding of the individual's hemodynamic profile which would trigger therapeutic interventions that improve patient outcomes. Nevertheless, even with the current diversity of hemodynamic devices available, the PAC remains a valuable tool in a wide variety of clinical settings. The authors present a review exposing the benefits of the PAC, current clinical recommendations for its use, mortality and survival profile, its role in goal-directed therapy, and other applications of the PAC beyond cardiac surgery and the intensive care unit.
自其临床应用以来，肺动脉导管（PAC）的使用一直存在诸多争议，主要与不明确的临床适应证和其置入相关的并发症有关。目前，对 PAC 的最重要批评之一是其血流动力学测量结果的解释不明确，因此，将这些数据转化为具体的治疗干预措施也存在不明确性。PAC 的普及源于它提供了无法通过临床检查获得的血流动力学数据。假设这些信息可以更好地了解个体的血流动力学特征，从而触发改善患者预后的治疗干预措施。然而，即使目前有多种血流动力学设备可供选择，PAC 在广泛的临床环境中仍然是一种有价值的工具。作者回顾了 PAC 的益处、目前其使用的临床建议、死亡率和生存率、在目标导向治疗中的作用，以及除心脏手术和重症监护室外 PAC 的其他应用。
