[The pulmonary artery catheter-Not a niche tool but often a must]

The pulmonary artery catheter (PAC) is the only hemodynamic monitoring tool that continuously integrates systemic blood flow, global oxygen balance, cardiopulmonary interactions and right ventricular function. Meta-analyses show that PAC-guided treatment reduces morbidity and mortality in high-risk surgical patients. Additionally, multiple observational and register data suggest a survival benefit in cardiogenic shock. Despite this evidence the use of PAC has declined in Germany in contrast to the rest of the world, with a concomitant loss of clinical expertise in the use of this monitoring modality. Current data clearly indicate that PAC use and correct data interpretation are not optional skills but core competencies in anesthesiology and intensive care medicine.