The Arc of the Pulmonary Artery Catheter

Medical Devices of the Chest

“…A catheter tip positioned in the right atrium increases the risk of perforation and cardiac arrhythmia (16,22). The same holds true for dialysis catheters.…”

“…Vascular catheters of various types are now routinely used for monitoring hemodynamic function; for performing hemodialysis; and for administering fluids, medications, and nutrition ( Fig 16) (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Some catheters are designed for short-term use in the postoperative or intensive care unit setting, whereas others are implanted for long-term use, such as those used in cancer patients (11,12).…”

“…Even though these catheters are widely accepted and widely used, there are no definitive studies demonstrating their benefit (15,16).…”

“…Complications of catheter insertion vary with the catheters used and the sites employed (2,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Catheter malposition usually involves the catheter passing into a tributary vessel rather than the one sought (Fig 20).…”

Medical technology in the intensive care unit

“…Even the most commonly used technologies in critical care often have been poorly evaluated or have not been shown to positively influence patient outcomes [3,80]. A few examples of technologies for which the supporting evidence is equivocal or even lacking include the use of bronchoscopic alveolar lavage for the diagnosis of ventilator-associated pneumonia [81][82][83][84][85][86], pulmonary artery catheters in the management of the acute respiratory distress syndrome [87][88][89], and esophageal Doppler probes for the measurement of cardiac output [90,91]. The ongoing controversy surrounding the use of the pulmonary artery catheter [89] highlights many of the problems involved with technology assessment.…”