Aspects of pulmonary artery catheterization in critical care

The concept of floating a balloon-tipped catheter into the pulmonary artery was first described in 1970 by Swan et al. Since then, many issues have surrounded the use of these catheters. Of particular concern for many physicians was the incidence of complications associated with use of the catheters. A group of clinicians have endeavoured to show the usefulness of the pulmonary artery catheter (PAC), but showing significant improvement to patient outcome has proved difficult. Physicians and nurses have demonstrated poor knowledge and skills associated with use of the catheter which must be overcome before conclusive benefits of the catheter can be demonstrated. Training nurses to use a PAC correctly has been highlighted in reducing the number of technical problems associated with the catheter, which in turn improves the accuracy of haemodynamic data obtained. Unfortunately, training programmes are few and far between, and this is an issue that must be addressed by critical care nurse managers. In this review of the literature regarding PACs and their use in the care of the critically ill patients, the role of the nurse is discussed with recommendations for practice.