PubMed · 9263107
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M R England, M C Murphy. 1997. A knotty problem.. https://doi.org/10.1016/s1053-0770(97)90041-0
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The pulmonary artery catheter (PAC) has been in use for more than 30 years. The amount and detail of hemodynamic information provided by the PAC cannot be matched by any other single technology. Whether or not this information makes a difference in the clinical outcomes of critically ill patients is uncertain, however. The Pulmonary Artery Catheter Consensus Conference scrutinized the available research data on the catheter and provided guidelines for clinicians on its use. This article summarizes the controversy and the guidelines available for use of the PAC. It notes the need for further research on patient outcomes.
The pulmonary artery catheter provides the opportunity to acquire indirectly important diagnostic and therapeutic information about the function of the two pumping chambers of the heart--the right and left ventricles--during the two phases of the cardiac cycle--systole and diastole. Appropriate use of hemodynamic data acquired via the pulmonary artery catheter requires the accurate measurement, analysis, and interpretation of hemodynamic pressure waveforms.
Pulmonary artery pressures and arterial pressures are important hemodynamic measurements utilized in clinical management decision making for critically ill patients. Studies have demonstrated a concerning rate of measurement error, often due to technical errors. Zeroing, leveling, and dynamic response testing are essential components of assuring the quality of measurements. This article describes a multilevel approach to assuring the accuracy of measurements. It includes the physics underlying each of these principles, criteria for judging the efficacy of the dynamic response, and clinically applicable methods for measuring the natural frequency and damping coefficient of pressure monitoring systems.