Pulmonary artery catheterisation. An assessment of risks and benefits in 220 surgical patients

The benefits and risks of pulmonary artery catheterisation were assessed in 220 patients having cardiac or vascular surgery. Prior to induction of anaesthesia 20% of patients had pulmonary artery wedge pressure measurements which indicated the need for blood volume support, vasodilator therapy or modification of the anaesthetic induction technique. Of those patients for cardiac surgery, 38% had important changes before cardiopulmonary bypass requiring blood volume support or vasodilator therapy. These changes were not reflected by similar changes in the central venous pressure. The risks of the technique were minimal. Minor complications occurred in 25% of patients (transient arrhythmias) and more serious complications occurred in 3.6% of patients. There was no mortality or long-term sequelae. We conclude that the benefits of pulmonary artery catheterisation outweigh its risks in patients having major cardiac and vascular surgery.