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EDITOR,--Tom Woodcock and Adrian P H Steele both concentrate on the issue of pulmonary artery catheterisation in critically ill patients, but my main message was the importance of using high technology investigations to complement rather than replace clinical skills in patients who are not acutely ill. I am aware that clinical signs can be unhelpful in desperately ill patients with severe circulatory problems, but that does not mean that clinical signs can be ignored. I agree with both Woodcock and Steele that assessment by Swan-Ganz catheterisation is crucially important in acute intensive care. This makes it all the more vital that all who use the technique fully understand its value and limitations and do not ignore clinical features entirely.
I thank Woodcock for pointing out that the page numbers of two of my references were wrong, and I apologise for this. I do not know what he means by his
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