BMJ 1996;313:763-764 (28 September)

Editorials

Swan song for the Swan-Ganz catheter?

The use of pulmonary artery catheters probably needs re-evaluation--but they should not be banned

An American study published earlier this month has shown that the use of a pulmonary artery catheter is associated with increased mortality in a wide range of conditions, including many of the accepted indications for using a catheter.1 Is this finding unexpected--and what should we do about it?

Connors et al retrospectively reviewed 5735 critically ill patients with one of nine prespecified disease categories treated in 1989-94. They assessed the severity of illness in all patients and compared the outcome in those who received and those who did not receive a pulmonary artery catheter within the first 24 hours of care. The patients receiving a pulmonary artery catheter had higher APACHE III scores and lower predicted survival at two months. They also had higher mortality, length of stay, and financial costs. To compare with those who . . . [Full text of this article]


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