[Swan Ganz catheter. Experts opinion]

Area of Science:

• Cardiology
• Medical Device Safety
• Clinical Decision Making

Background:

• Doubts exist regarding the safety of the Swan-Ganz catheter (SGC).
• The Argentine Society of Cardiology's Emergency Council convened experts to assess SGC use.
• The RAND-UCLA appropriateness method was employed to evaluate SGC indications.

Framework:

• Experts reviewed scientific evidence on SGC use.
• Clinical scenarios were developed based on expert consensus.
• Panellists rated the benefit-to-harm ratio of SGC in various clinical situations.

Implementation:

• Hypothetical clinical situations were presented to cardiologists for individual evaluation.
• A 9-point scale assessed the benefit-harm ratio, with scores 1-3 (inappropriate), 4-6 (uncertain), and 7-9 (appropriate).
• Agreement and disagreement rates among panellists were analyzed.

Implications:

• High disagreement rates were observed in SGC indications among cardiologists.
• SGC use was favored in cases of shock and myocardial dysfunction, especially with organ dysfunction.
• Panelists deemed SGC not useful for patients without organ failure.