Vender J S
Department of Anesthesiology, Northwestern University Medical School, Evanston, IL, USA.
J Cardiothorac Vasc Anesth. 1998 Apr;12(2 Suppl 1):9-12.
Selected studies showing both positive and negative outcomes with the use of pulmonary artery catheters (PACs) are reviewed. Indications for use of a PAC are controversial, although clearly the "red cap syndrome" is an indication for its insertion. There are sufficient data as well as personal experience to suggest that PACs do make a difference in the management of critically ill patients. Attention is focused on the level of physician expertise in interpreting data provided by PAC monitoring as the most critical limitation on the physician's ability to make appropriate clinical decisions. Studies are reviewed that addressed physician level of expertise related to PAC insertion, complications, data and waveform interpretation, and management. User knowledge clearly is suboptimal. Before attempting to draw conclusions from outcome studies, criteria for appropriate use need to be developed and clinician knowledge needs to be significantly improved.
本文回顾了一些关于使用肺动脉导管（PAC）显示出阳性和阴性结果的选定研究。尽管“红帽综合征”显然是插入PAC的一个指征，但PAC的使用指征仍存在争议。有足够的数据以及个人经验表明，PAC在危重症患者的管理中确实能发挥作用。注意力集中在医生解读PAC监测提供的数据的专业水平上，这是对医生做出适当临床决策能力的最关键限制。本文回顾了一些研究，这些研究涉及与PAC插入、并发症、数据和波形解读以及管理相关的医生专业水平。使用者的知识显然并不理想。在试图从结果研究中得出结论之前，需要制定适当使用的标准，并且临床医生的知识需要显著提高。
