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The pulmonary artery catheter: is it still alive?

De Backer, Daniela; Vincent, Jean-Louisb

Current Opinion in Critical Care: June 2018 - Volume 24 - Issue 3 - p 204–208
doi: 10.1097/MCC.0000000000000502

Purpose of review The present review discusses the current role of the pulmonary artery catheter (PAC) in the hemodynamic monitoring of critically ill patients.

Recent findings The PAC has an important role in the characterization and management of hemodynamic alterations in critically ill patients. Use of the PAC has decreased in the last 30 years because of recent advances in less invasive hemodynamic monitoring techniques, in particular transpulmonary thermodilution and echocardiography, combined with the publication of the results of several randomized trials that failed to show improvements in outcome with the use of the PAC in various settings. Although it is obvious that the PAC should not be used in most critically ill patients, the PAC is still indicated in some patients with circulatory and/or respiratory failure, especially when associated with pulmonary hypertension or left heart dysfunction. As for any technique, optimal PAC use requires expertise in insertion, acquisition, and interpretation of measurements. The decrease in use of the PAC may unfortunately limit exposure of junior doctors and nurses to this device, so that they become less familiar with using the PAC, making it more complicated and less optimal.

Summary The PAC still has an important role in the cardiopulmonary monitoring of critically ill patients.

aDepartment of Intensive Care, CHIREC Hospitals

bDepartment of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

Correspondence to Daniel De Backer, MD, PhD, Department of Intensive Care, CHIREC Hospitals, Boulevard du Triomphe 201, B-1160 Brussels, Belgium. Tel: +32 2 434 9324; fax: +32 2 434 9312; e-mail:

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