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Abstract:
Right heart catheterization, first reported in 1905, is now used for bedside assessment and management of the critically ill patient. A Swan-Ganz catheter and pulmonary artery pressure monitoring are the tools employed. In spite of the complications cited, the occurrence of hazard to the patient is infrequent. The catheter is particularly valuable in the hemodynamic evaluation of cardiac function. Right and left heart pump performance can be assessed by pressure measurements. The ability of the left heart to provide an adequate cardiac output can be numerically calculated, and its adequacy at a cellular level can be evaluated by determining arterial-venous oxygen saturation difference. One of the more important and newest uses of the Swan-Ganz catheter is the preventive function it plays in anesthesia administration. Implications of the Swan-Ganz catheter for nursing practice are: (1) explanation and support to patient and family; (2) technical understanding and knowledge of set-up; (3) care and maintenance of the catheter after insertion; (4) the understanding of physiologic principles underlying the use of the catheter; and, most important, (5) ability to correlate clinical observations and physiologic changes occurring in the patient with pressure measurements.