The pulmonary artery catheter: uses and controversies

The pulmonary artery catheter is an invasive hemodynamic monitor that can provide diagnostic information in situations where history and physical examination are inconclusive. Assisting the physician in therapeutic decisions has added to its clinical value. Understanding the information it provides and making thoughtful therapeutic decisions lie at the core of its use. Despite its use, the PA catheter has been the center of great controversy. Clearly the paucity of prospective randomized trials proving its efficacy is alarming. The inability of physicians to interpret the provided data properly is also unacceptable. Although instituting a moratorium on its use may be extreme, limiting its use to approved indications seems more appropriate. In the future, ready availability of other less invasive methods such as echocardiography may allow clinicians to become less reliant on the PA catheter. Until then, clinicians would be served best by comprehending the intricacies and the limitations of this sophisticated instrument.