Background Since pulmonary artery balloon flotation catheterization was first introduced in 1970, by HJ Swan and W Ganz, it has been widely disseminated as a diagnostic tool without rigorous evaluation of its clinical utility and effectiveness in critically ill patients. A pulmonary artery catheter (PAC) is inserted through a central venous access into the right side of the heart and floated into the pulmonary artery. PAC is used to measure stroke volume, cardiac output, mixed venous oxygen saturation and intracardiac pressures with a variety of additional calculated variables to guide diagnosis and treatment. Complications of the procedure are mainly related to line insertion. Relatively uncommon complications include cardiac arrhythmias, pulmonary haemorrhage and infarct, and associated mortality from balloon tip rupture. Objectives To provide an up-to-date assessment of the effectiveness of a PAC on mortality, length of stay (LOS) in intensive care unit (ICU) and hospital and cost of care in adult intensive care patients.

methyldopa group and 22.5% in the nifedipine group (P < 0.001). The reduction of preeclampsia was from 48.8% to 26.5% in the methyldopa group and 28.7% in the nifedipine group (P < 0.001). In turn, there were reductions in preterm birth and neonatal intensive care unit admissions as well (Pregnancy Hypertens 2019;17:54-58). In addition, there is a large ongoing trial in the United States that is randomizing women to treatment versus no treatment that should finish over the next couple of years. Unfortunately, we will not know from either of these studies whether we should treat patients within the new category of 130-139 systolic or 80-89 diastolic. However, if the larger study produces outcomes similar to the smaller trial above and given the increased rates of perinatal morbidity seen in the current study, I would suggest that careful consideration of treating these individuals.-ABC)

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