Pulmonary artery catheters : effects on patient outcome

Pulmonary artery catheters (PAC) have been a topic of discussion in the critical care community of late. There have been studies that show benefits from the use of this catheter and some other studies show no benefits. Currently there are no standards in place for education, training, or for insertion guidelines of the PAC. Literature review regarding the PAC addressed the following research question: Does medical therapy, guided by the PAC, improve patient outcome? There is no agreement among the 15 studies reviewed. Five of nine studies that examined goal oriented therapy to supranormal hemodynamic values found a sub category of patients that had reduced mortality rates. This finding was limited to the patients that were able to reach the predetermined therapeutic goals regardless of randomization to a protocol or control group. Large, multi-center, prospective, randomized, controlled trials are underway by the Canadian Critical Care Trials Group and by the National Institutes of Health. These studies should help to better determine those groups of patients who may benefit from the use of the PAC. Nurses remain the primary individuals responsible for gathering, interpreting, and reporting data obtained with the PAC. By understanding the existing body of research nurses will have a solid foundation to assist physicians and patients in providing the best treatment options