Pulmonary circulation pressures in surgical patients. The use of the Swan-Ganz catheter

Experiences with the Swan-Ganz catheter in 'high risk' surgical intensive care patients are described. After description of the catheter and catheterization technique, normal values from the literature are presented. Attention is drawn to the occurrence of artefacts in the pressure curve, which can lead to the inference of faulty results from the measurements. Attention is also drawn to the effect of intrathoracic pressure on pulmonary vascular pressures. A review of possible complications is given, with recommendations how these may be avoided or at least reduced to a minimum. The authors' material is used to demonstrate the value of the catheter, showing that the CVP is not always a trustworthy parameter for hemodynamic monitoring. The conclusion is drawn that the 'high risk' patient on the surgical intensive care unit gains from the use of the Swan-Ganz catheter.