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Meta-Analysis
. 2013 Feb 28;2013(2):CD003408.
doi: 10.1002/14651858.CD003408.pub3.

Pulmonary artery catheters for adult patients in intensive care

Sujanthy S Rajaram  1 , Nayan K Desai, Ankur Kalra, Mithil Gajera, Susan K Cavanaugh, William Brampton, Duncan Young, Sheila Harvey, Kathy Rowan
Affiliations
Meta-Analysis

Pulmonary artery catheters for adult patients in intensive care

Sujanthy S Rajaram et al. Cochrane Database Syst Rev. .

Abstract

Background: Since pulmonary artery balloon flotation catheterization was first introduced in 1970, by HJ Swan and W Ganz, it has been widely disseminated as a diagnostic tool without rigorous evaluation of its clinical utility and effectiveness in critically ill patients. A pulmonary artery catheter (PAC) is inserted through a central venous access into the right side of the heart and floated into the pulmonary artery. PAC is used to measure stroke volume, cardiac output, mixed venous oxygen saturation and intracardiac pressures with a variety of additional calculated variables to guide diagnosis and treatment. Complications of the procedure are mainly related to line insertion. Relatively uncommon complications include cardiac arrhythmias, pulmonary haemorrhage and infarct, and associated mortality from balloon tip rupture.

Objectives: To provide an up-to-date assessment of the effectiveness of a PAC on mortality, length of stay (LOS) in intensive care unit (ICU) and hospital and cost of care in adult intensive care patients.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 12); MEDLINE (1954 to January 2012); EMBASE (1980 to January 2012); CINAHL (1982 to January 2012), and reference lists of articles. We contacted researchers in the field. We did a grey literature search for articles published until January 2012.

Selection criteria: We included all randomized controlled trials conducted in adults ICUs, comparing management with and without a PAC.

Data collection and analysis: We screened the titles and abstracts and then the full text reports identified from our electronic search. Two authors (SR and MG) independently reviewed the titles, abstracts and then the full text reports for inclusion. We determined the final list of included studies by discussion among the group members (SR, ND, MG, AK and SC) with consensus agreement. We included all the studies that were in the original review. We assessed seven domains of potential risk of bias for the included studies. We examined the clinical, methodological and statistical heterogeneity and used random-effects model for meta-analysis. We calculated risk ratio for mortality across studies and mean days for LOS.

Main results: We included 13 studies (5686 patients). We judged blinding of participants and personnel and blinding of outcome assessment to be at high risk in about 50% of the included studies and at low risk in 25% to 30% of the studies. Regardless of the high risk of performance bias these studies were included based on the low weight the studies had in the meta-analysis. We rated 75% of the studies as low risk for selection, attrition and reporting bias. All 13 studies reported some type of hospital mortality (28-day, 30-day, 60-day or ICU mortality). We considered studies of high-risk surgery patients (eight studies) and general intensive care patients (five studies) separately as subgroups for meta-analysis. The pooled risk ratio (RR) for mortality for the studies of general intensive care patients was 1.02 (95% confidence interval (CI) 0.96 to 1.09) and for the studies of high-risk surgery patients the RR was 0.98 (95% CI 0.74 to 1.29). Of the eight studies of high-risk surgery patients, five evaluated the effectiveness of pre-operative optimization but there was no difference in mortality when these studies were examined separately. PAC did not affect general ICU LOS (reported by four studies) or hospital LOS (reported by nine studies). Four studies, conducted in the United States (US), reported costs based on hospital charges billed, which on average were higher in the PAC groups. Two of these studies qualified for analysis and did not show a statistically significant hospital cost difference (mean difference USD 900, 95% CI -2620 to 4420, P = 0.62).

Authors' conclusions: PAC is a diagnostic and haemodynamic monitoring tool but not a therapeutic intervention. Our review concluded that use of a PAC did not alter the mortality, general ICU or hospital LOS, or cost for adult patients in intensive care. The quality of evidence was high for mortality and LOS but low for cost analysis. Efficacy studies are needed to determine if there are optimal PAC-guided management protocols, which when applied to specific patient groups in ICUs could result in benefits such as shock reversal, improved organ function and less vasopressor use. Newer, less-invasive haemodynamic monitoring tools need to be validated against PAC prior to clinical use in critically ill patients.

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Conflict of interest statement

S Harvey, K Rowan, D Young and W Brampton are authors on one of the citations included in the original review and update (Harvey 2005).

All other authors: none known.

Figures

1
1
PAC for adult patients intensive care study flow diagram. O ‐ Original review in 2006. U ‐ Updated review in 2012.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Funnel plot of comparison: 5 PAC versus no PAC outcome: 5.1 Combined mortality of all studies.
5
5
Forest plot of comparison: 5 PAC versus no PAC (combined medical and surgical patients), outcome: 5.1 Combined mortality of all studies.
6
6
Forest plot of comparison: 1 PAC versus no PAC, outcome: 1.2 All types mortality (high‐risk surgical patients).
1.1
1.1. Analysis
Comparison 1 Combined mortality: PAC versus no PAC, Outcome 1 Combined mortality of all studies.
2.1
2.1. Analysis
Comparison 2 PAC versus no PAC, Outcome 1 All types mortality (general intensive care patients).
2.2
2.2. Analysis
Comparison 2 PAC versus no PAC, Outcome 2 All types mortality (high‐risk surgical patients).
3.1
3.1. Analysis
Comparison 3 ICU length of stay PAC versus no PAC, Outcome 1 ICU length of stay (general intensive care patients).
4.1
4.1. Analysis
Comparison 4 Hospital length of stay: PAC versus no PAC, Outcome 1 Hospital length of stay (general intensive care patients).
4.2
4.2. Analysis
Comparison 4 Hospital length of stay: PAC versus no PAC, Outcome 2 Hospital length of stay (high‐risk surgical patients).
5.1
5.1. Analysis
Comparison 5 Cost of care: PAC versus no PAC, Outcome 1 Cost of care (hospital charges, 1000's of US dollars).
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Bender 1997 {published data only}
    1. Bender JS, Smith‐Meek MA, Jones CE. Routine pulmonary artery catheterization does not reduce morbidity and mortality of elective vascular surgery: results of a prospective randomized trial. Annals of Surgery 1997;226(3):229‐37. [MEDLINE: ] - PMC - PubMed
Berlauk 1991 {published data only}
    1. Berlauk JF, Abrams JH, Gilmour IJ, O'Connor R, Knighton DR, Cerra FB. Preoperative optimization of cardiovascular hemodynamics improves outcome in peripheral vascular surgery. A prospective, randomized clinical trial. Annals of Surgery 1991;214(3):289‐99. [MEDLINE: ] - PMC - PubMed
Guyatt 1991 {published data only}
    1. Guyatt G. A randomized control trial of right‐heart catheterization in critically ill patients. Ontario Intensive Care Study Group. Journal of Intensive Care Medicine 1991;6(2):91‐5. [MEDLINE: ] - PubMed
Harvey 2005 {published data only}
    1. Harvey S, Harrison D, Singer M, Ashcroft J, Jones C, Elbourne D, et al. An assessment of the clinical effectiveness of pulmonary artery catheters in patient management in intensive care (PAC‐Man): a randomised controlled trial. Lancet 2005;366(9484):472‐7. [MEDLINE: ] - PubMed
Isaacson 1990 {published data only}
    1. Isaacson IJ, Lowdon JD, Berry AJ, Smith RB 3d, Knos GB, Weitz FI, et al. The value of pulmonary artery catheter and central venous monitoring in patients undergoing abdominal aortic reconstructive surgery: a comparative study of two selected, randomized groups. Journal of Vascular Surgery 1990;12(6):754‐60. [MEDLINE: ] - PubMed
Joyce 1990 {published data only}
    1. Joyce W, Provan JL, Ameli FM, McEwan MM, Jelenich S, Jones DP. The role of central haemodynamic monitoring in abdominal aortic surgery. A prospective randomised study. European Journal of Vascular Surgery 1990;4(6):633‐6. [MEDLINE: ] - PubMed
NHLBI 2006 {published data only}
    1. NHLBI 2006 National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wheeler AP, Bernard GR, Thompson BT, Schoenfeld D, Wiedemann HP, deBoisblanc B, et al. Pulmonary‐artery versus central venous catheter to guide treatment of acute lung injury. The New England Journal of Medicine 2006;354(21):2213‐24. [MEDLINE: ] - PubMed
Pearson 1989 {published data only}
    1. Pearson KS, Gomez MN, Moyers JR, Carter JG, Tinker JH. A cost/benefit analysis of randomized invasive monitoring for patients undergoing cardiac surgery [see comments]. Anesthesia and Analgesia 1989;69(3):336‐41. [MEDLINE: ] - PubMed
Rhodes 2002 {published data only}
    1. Rhodes A, Cusack RJ, Newman PJ, Grounds M, Bennett D. A randomised, controlled trial of the pulmonary artery catheter in critically ill patients. Intensive Care Medicine 2002;28(3):256‐64. [MEDLINE: ] - PubMed
Richard 2003 {unpublished data only}
    1. Richard C, Warszawski J, Anguel N, Deye N, Combes A, Barnoud D, et al. Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA 2003;290(20):2713‐20. [MEDLINE: ] - PubMed
Sandham 2003 {published data only}
    1. Sandham JD, Hull RD, Brant RF, Knox L, Pineo GF, Doig CJ, et al. A randomized, controlled trial of the use of pulmonary‐artery catheters in high‐risk surgical patients. The New England Journal of Medicine 2003;348(1):5‐14. [MEDLINE: ] - PubMed
Shoemaker 1988 {published data only}
    1. Shoemaker WC, Appel PL Kram HB, Waxman K, Lee TS. Prospective trial of supranormal values of survivors as therapeutic goals in high‐risk surgical patients. Chest 1988;94(6):1176‐86. [MEDLINE: ] - PubMed
Valentine 1998 {published data only}
    1. Valentine RJ, Duke ML, Inman MH, Grayburn PA, Hagino RT, Kakish HB, et al. Effectiveness of pulmonary artery catheters in aortic surgery: A randomized trial. Journal of Vascular Surgery 1998;27(2):203‐12. [MEDLINE: ] - PubMed

References to studies excluded from this review

Bach 1992 {published data only}
    1. Bach A, Bohrer H, Gleiss HK. Safety of a guidewire technique for replacement of pulmonary artery catheters. Journal of Cardiothoracic and Vascular Anesthesia 1992;6:711‐4. [MEDLINE: ] - PubMed
Barone 2001 {published data only}
    1. Barone JE, Tucker JB, Rassias D, Corvo PR. Routine perioperative pulmonary artery catheterization has no effect on rate of complications in vascular surgery: a meta‐analysis. The American Surgeon 2001;67:674‐9. [MEDLINE: ] - PubMed
Boldt 1995 {published data only}
    1. Boldt J, Heesen M, Muller M, Hempelmann G. Continuous monitoring of critical patients with a newly developed pulmonary arterial catheter. A cost analysis. Anaesthetist 1995;44:423‐8. [MEDLINE: ] - PubMed
Bonazzi 2002 {published data only}
    1. Bonazzi M, Gentile F, Biasi GM, Migliavacca S, Esposti D, Cipolla M, et al. Impact of perioperative haemodynamic monitoring on cardiac morbidity after major vascular surgery in low risk patients. A randomised pilot trial. European Journal of Vascular Surgery 2002;23:445‐51. [MEDLINE: ] - PubMed
Boyd 1993 {published data only}
    1. Boyd O, Grounds RM, Bennett ED. A randomized clinical trial of the effect of deliberate perioperative increase of oxygen delivery on mortality in high‐risk surgical patients. JAMA 1993;270:2699‐707. [MEDLINE: ] - PubMed
Brazzi 1995 {published data only}
    1. Brazzi L, Gattioni L, Latini R, Tognoni G. The SvO2 Study: General design and results of the feasibility phase of a multicenter, randomized trial of three different hemodynamic approaches and two monitoring techniques in the treatment of critically ill patients. Controlled Clinical Trials 1995;16:74‐87. [MEDLINE: ] - PubMed
Cobb 1992 {published data only}
    1. Cobb DK, High KP, Sawyer RG, Sable CA, Adams RB, Lindley DA, et al. A controlled trial of scheduled replacement of central venous and pulmonary artery catheters. The New England Journal of Medicine 1992;327:1062‐8. [MEDLINE: ] - PubMed
Cohen 1998 {published data only}
    1. Cohen Y, Fosse JP, Karoubi P, Reboul‐Marty J, Dreyfuss D, Hoang P, et al. The "hands off" catheter and the prevention of systemic infections associated with pulmonary artery catheter: a prospective study. American Journal of Respiratory and Critical Care Medicine 1998;157:284‐7. [MEDLINE: ] - PubMed
Eyer 1990 {published data only}
    1. Eyer S, Brummitt C, Crossley K, Siegel R, Cerra F. Catheter‐related sepsis: prospective, randomized study of three methods of long‐term catheter maintenance. Critical Care Medicine 1990;18:1073‐9. [MEDLINE: ] - PubMed
Girbes 1999 {published data only}
    1. Girbes AR, Ligtenberg JJ, Sonneveld JP, Wierda JM. Prevention of hypotension after induction of anesthesia after preoperative tune‐up. A preliminary report of the Groningen Tune‐up Study. Netherlands Journal of Medicine 1999;54:213‐4. [MEDLINE: ] - PubMed
Holmes 1997 {published data only}
    1. Holmes DR Jr, Califf RM, Werf F, Berger PB, Bates ER, Simoons ML, et al. Difference in countries' use of resources and clinical outcome for patients with cardiogenic shock after myocardial infarction: results from the GUSTO trial. Lancet 1997;349:75‐8. [MEDLINE: ] - PubMed
Kearns 1993 {published data only}
    1. Kearns PJ. A controlled trial of scheduled replacement of central venous and pulmonary catheters. Journal of Parenteral and Enteral Nutrition 1993;17:292. [MEDLINE: ] - PubMed
Latour‐Perez 1997 {published data only}
    1. Latour‐Perez J, Calvo‐Embuena R. Evaluation of the use of the pulmonary artery catheter in patients with acute myocardial infarct: the PAEEC study. Project of the Epidemiologic Analysis of Critical Illness. Medicina Clínica 1998;110:721‐6. [MEDLINE: ] - PubMed
Mermel 1991 {published data only}
    1. Mermel LA, McCormick RD, Springman SR, Maki DG. The pathogenesis and epidemiology of catheter‐related infection with pulmonary artery Swan‐Ganz catheters: a prospective study utilizing molecular subtyping. The American Journal of Medicine 1991;91:197S‐205S. [MEDLINE: ] - PubMed
Mitchell 1992 {published data only}
    1. Mitchell JP, Schuller D, Calandrino FS, Schuster. Improved outcome based on fluid management in critically ill patients requiring pulmonary artery catheterization. The American Review of Respiratory Disease 1992;145:990‐8. [MEDLINE: ] - PubMed
Orlando 1985 {published data only}
    1. Orlando R, Nelson LD, Civetta JM. Invasive pre‐operative evaluation of high‐risk patients. Critical Care Medicine 1985;13:26.
Raybin 1989 {published data only}
    1. Raybin DM. Pulmonary artery catheterization. Chest 1989;96:957. [MEDLINE: ] - PubMed
Schultz 1985 {published data only}
    1. Schultz RJ, Whitfield GF, LaMura JJ, Raciti A, Krishnamurthy S. The role of physiologic monitoring in patients with fractures of the hip. The Journal of Trauma 1985;25:309‐16. [MEDLINE: ] - PubMed
Senagore 1987 {published data only}
    1. Senagore A, Waller JD, Bonnell BW, Bursch LR, Scholten DJ. Pulmonary artery catheterization: a prospective study of internal jugular and subclavian approaches. Critical Care Medicine 1987;15:35‐7. [MEDLINE: ] - PubMed
Shoemaker 1990 {published data only}
    1. Shoemaker WC, Kram HB, Appel PL, Fleming AW. The efficacy of central venous and pulmonary artery catheters and therapy based upon them reducing mortality and morbidity. Archives in Surgery 1990;125:1332‐7. [MEDLINE: ] - PubMed
Sola 1993 {published data only}
    1. Sola JE, Bender JS. Use of the pulmonary artery catheter to reduce operative complications. The Surgical Clinics of North America 1993;73:253‐64. [MEDLINE: ] - PubMed
Stewart 1998 {published data only}
    1. Stewart RD, Psyhojos T, Lahey SJ, Levitsky S, Campos CT. Central venous catheter use in low‐risk coronary artery bypass grafting. The Annuals of Thoracic Surgery 1998;66:1306‐11. [MEDLINE: ] - PubMed
Stout 2006 {published data only}
    1. Stout CL, Water JM, Thompson WM, Bowers EW, Sheppard, S.W, Tewari AM, et al. Impedance cardiography: can it replace thermodilution and the pulmonary artery catheter?. American Surgeon. 2006;72(8):728‐32, discussion 733‐4. - PubMed
Stubbig 1992 {published data only}
    1. Bach A, Stubbig K, Geiss HK. Infectious risk of replacing venous catheters by the guide‐wire technique. Zentralblatt für Hygiene und Umweltmedizin 1992;193:150‐9. [MEDLINE: ] - PubMed
Suttner 2006 {published data only}
    1. Suttner A, Schollhorn T, Boldt J, Mayer J, Rohm J, Lang K, et al. Non invasive assessment of cardiac output using thoracic electrical bioimpedence in hemodynamically stable and unstable patients after cardiac surgery: a comparison with pulmonary artery thermodilution. Intensive Care Medicine 2006;32:2053‐8. [DOI: 10.1007/s00134-006-0409-x] - DOI - PubMed
Takala 2011 {published data only}
    1. Takala J, Ruokonen E, Tenhunen JJ, Parviainen I, Jakob SM. Early non‐invasive cardiac output monitoring in hemodynamically unstable intensive care patients: A multi‐center randomized controlled trial. Critical Care 2011;15:R148. - PMC - PubMed
Tuman 1989 {published data only}
    1. Tuman KJ, McCarthy RJ, Spiess BD, DaValle M, Hompland SJ, Dabir R, et al. Effect of pulmonary artery catheterization on outcome in patients undergoing coronary artery surgery. Anesthesiology 1989;70:199‐206. [MEDLINE: ] - PubMed
Wilson 1999 {published data only}
    1. Wilson J, Woods I, Fawcett J, Whall R, Dibb W, Morris C, et al. Reducing the risk of major elective surgery: randomised controlled trial of preoperative optimisation of oxygen delivery. BMJ 1999;318:1099‐103. [MEDLINE: ] - PMC - PubMed
Yu 1993 {published data only}
    1. Yu M, Levy MM, Smith P, Takiguchi SA, Miyasaki A, Myers SA. Effect of maximizing oxygen delivery on morbidity and mortality rates in critically ill patients: a prospective, randomized, controlled trial. Critical Care Medicine 1993;21:830‐8. [MEDLINE: ] - PubMed
Yu 1995 {published data only}
    1. Yu M, Takanishi D, Myers SA, Takiguchi SA, Severino R, Hasaniya N, et al. Frequency of mortality and myocardial infarction during maximizing oxygen delivery: a prospective, randomized trial. Critical Care Medicine 1995;23:1025‐32. [MEDLINE: ] - PubMed
Yu 2011 {published data only}
    1. YuM, Pei K, Moran S, Edwards KD, Domingo S, Steinemann S, et al. A prospective randomized trial using blood volume analysis in addition to pulmonary artery catheter, compared with pulmonary artery catheter alone, to guide shock resuscitation in critically ill surgical patients. Shock (Augusta, Ga.) 2011;35(3):220‐8. - PubMed
Ziegler 1997 {published data only}
    1. Ziegler DW, Wright JG, Choban PS, Flancbaum L. A prospective randomized trial of preoperative "optimization" of cardiac function in patients undergoing elective peripheral vascular surgery. Surgery 1997;122:584‐92. [MEDLINE: ] - PubMed

Additional references

ASA task force on PAC 2003
    1. American Society of Anesthesiologists Task Force on Pulmonary Artery Catheterization. Practice guidelines for pulmonary artery catheterization: an updated report by the American Society of Anesthesiologists Task Force on Pulmonary Artery Catheterization. Anesthesiology 2003 Oct;99(4):988‐1014. [MEDLINE: ] - PubMed
Assoc. Press 1996
    1. Associated Press. Heart monitoring system may kill some patients. The Dallas Morning News 1996; Vol. Sept 18.
Binanay 2005
    1. Binanay C, Califf RM, Hasselblad V, O'Connor CM, Shah MR, Sopko G. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA 2005;294:1693‐4. [MEDLINE: ] - PubMed
Brienza 2009
    1. Brienza N, Giglio MT, Marucci M, Fiore T. Does perioperative hemodynamic optimization protect renal function in surgical patients? A meta‐analytic study. Critical Care Medicine 2009;37(6):2079‐90. [PUBMED: 19384211] - PubMed
Chatterjee 2009
    1. Chatterjee K. The Swan‐Ganz catheters: past, present, and future. A viewpoint. Circulation 2009;119:147‐52. [MEDLINE: ] - PubMed
Cochrane cost converter [Computer program]
    1. The Campbell and Cochrane Economics Methods Group. The CCEMG‐EPPI‐Centre cost converter. Version 1.2. The Campbell and Cochrane Economics Methods Group, http://eppi.ioe.ac.uk/costconversion/default.aspx.
Connors 1996
    1. Connors AF, Speroff TS, Dawson NV, Thomas C, Harell FE, Wagner D, et al. The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA 1996;276:889‐97. [MEDLINE: ] - PubMed
Cooper 1996
    1. Cooper AB, Doig GS, Sibbald WJ. Pulmonary artery catheters in the critically ill. Critical Care Clinics 1996;12:777‐93. [MEDLINE: ] - PubMed
Edwards Lifesciences 2012
    1. © 2012 Edwards Lifesciences LLC. Swan‐Ganz catheters, Monitoring catheters and Pulmonary Angiography catheters. http://www.edwards.com/products/pacatheters/pages/monitoringcatheters.aspx Down loaded on April 11, 2012. [on line version]
ESCAPE 2005
    1. The ESCAPE Investigators and ESCAPE Study Coordinators. Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness [The ESCAPE Trial]. JAMA 2005;294(13):1625‐33. - PubMed
ESICM 1991
    1. European Society of Intensive Care Medicine. Expert panel: the use of the pulmonary artery catheter. Intensive Care Medicine 1991;17(3):I‐VIII. [MEDLINE: ] - PubMed
Evans 2009
    1. Evans DC, Doraiswamy VA, Prosciak MP, Silviera M, Seamon MJ, Rodriguez Funes V, et al. Complications associated with pulmonary artery catheters: A comprehensive clinical review. Scandinavian Journal of Surgery 2009;98:199–208. [MEDLINE: ] - PubMed
Gattinoni 1995
    1. Gattinoni L, Brazzi L, Pelosi P, Latini R, Tognoni G, Pesenti A, et al. A trial of goal orientated hemodynamic therapy in critically ill patients.SvO2 Collaborative Group. The New England Journal of Medicine 1995;333:1025‐32. [MEDLINE: ] - PubMed
Gore 1987
    1. Gore JM, Goldberg RJ, Spodick DH, Alpert JS, Dalen JE. A community‐wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. Chest 1987;92:721‐7. [MEDLINE: ] - PubMed
Greenberg 2009
    1. Greenberg SB, Murphy GS, Vender JS. Current use of the pulmonary artery catheter. Current Opinion in Critical Care 2009;15(3):249‐53. [MEDLINE: ] - PubMed
Gurgel 2011
    1. Gurgel ST, do Nascimento P Jr. Maintaining tissue perfusion in high‐risk surgical patients: a systematic review of randomized clinical trials. Anesthesia and Analgesia 2011;112(6):1384‐91. [MEDLINE: ] - PubMed
Hadian 2007
    1. Hadian M, Pinsky MR. Functional hemodynamic monitoring. Current Opinion in Critical Care 2007;13(3):318‐23. [MEDLINE: ] - PubMed
Hamilton 2011
    1. Hamilton MA, Cecconi M, Rhodes A. A systematic review and meta‐analysis on the use of preemptive hemodynamic intervention to improve postoperative outcomes in moderate and high‐risk surgical patients. Anesthesia and Analgesia 2011;112(6):1392‐402. [MEDLINE: ] - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 [updated March 2011]. In: The Cochrane Library, 2011 Chichester, UK: John Wiley & Sons, Ltd.
Iberti 1990
    1. Iberti TJ, Fischer EP, Leibowitz AB, Panacek EA, Silverstein JH, Albertson TE. A multicenter study of physicians' knowledge of the pulmonary artery catheter. Pulmonary Artery Catheter Study Group. JAMA 1990;264(22):2928‐32. [MEDLINE: ] - PubMed
Iberti 1994
    1. Iberti TJ, Daily EK, Leibowitz AB, Schecter CB, Fischer EP, Silverstein JH. Assessment of critical care nurses' knowledge of the pulmonary artery catheter. The Pulmonary Artery Catheter Study Group. Critical Care Medicine 1994 Oct;22(10):1674‐8. [MEDLINE: ] - PubMed
Ivanov 2000
    1. Ivanov R, Allen J, Calvin J. The incidence of major morbidity in critically ill patients managed with pulmonary artery catheters: a meta‐analysis. Critical Care Medicine 2000;28:615‐9. [MEDLINE: ] - PubMed
Johnston 2008
    1. Johnston IG, Fraser JF, Sabapathy S, Kruger PS. The pulmonary artery catheter in Australasia: a survey investigating intensive care physicians' knowledge and perception of future trends in use. Anaesthesia and Intensive Care 2008;36(1):84‐9. [MEDLINE: ] - PubMed
Kern 2002
    1. Kern JW, Shoemaker WC. Meta‐analysis of hemodynamic optimization in high‐risk patients. Critical Care Medicine 2002 Aug;30(8):1686‐92. [MEDLINE: ] - PubMed
Lamperti 2012
    1. Lamperti M, Bodenham AR, Pittiruti M, Blaivas M, Augoustides JG, Elbarbary M, et al. International evidence‐based recommendations on ultrasound‐guided vascular access. Intensive Care Medicine 2012;38:1105–17. [DOI : 10.1007/s00134‐012‐2597‐x] - PubMed
PAC Consensus 1997
    1. Pulmonary Artery Catheter Consensus Conference Participants. Pulmonary Artery Catheter Consensus Statement. Critical Care Medicine 1997;25:910‐25. [MEDLINE: ] - PubMed
Pope 2010
    1. Pope JV, Jone AE, Gaieski DF, Arnold RC, Trzeciak S, Sharpiro NI. Multicenter study of central venous oxygen saturation (ScVO2) as a predictor of mortality in patients with sepsis. Annals of Emergency Medicine 2010;55:40‐6. [MEDLINE: ] - PMC - PubMed
RevMan 5.1 [Computer program]
    1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan) [Computer program]. Version 5.1 for Windows Copenhagen. The Cochrane Collaboration 2011. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Rivers 2001
    1. Rivers E, Nguyen B, Havstad S, et al. Early goal‐directed therapy in the treatment of severe sepsis and septic shock. The New England Journal of Medicine 2001;345:1368‐77. [MEDLINE: ] - PubMed
Shah 2005
    1. Shah MR, Hasselblad V, Stevenson LW, Binanay C, O'Connor CM, Sopko G, et al. Impact of pulmonary artery catheter in critically ill patients. Meta‐analysis of randomized clinical trials. JAMA 2005;294:1664‐70. [MEDLINE: ] - PubMed
Stevens 2005
    1. Stevens K, McCabe C, Jones C, Ashcroft J, Harvey S, Rowan K, on behalf of the PacMan Study Collaboration. The incremental cost effectiveness of withdrawing pulmonary artery catheters from routine use in critical care. The incremental cost effectiveness of withdrawing pulmonary artery catheters from routine use in critical care. Applied Health Economics and Health Policy 2005;4:257‐64. [MEDLINE: ] - PubMed
Swan 1970
    1. Swan HJ, Ganz W, Forrester J, Marcus H, Diiamond G, Chonette D. Catheterization of the heart in man with use of flow‐directed balloon‐tipped catheter. New England Journal of Medicine 1970;283:447‐51. [MEDLINE: ] - PubMed
Weiner 2007
    1. Wiener B, Chacko S, Cron SG, Cohen MZ. Guideline development and education to insure accurate and consistent pulmonary artery wedge pressure measurement by nurses in intensive care units. Dimensions of Critical Care Nursing 2007;26(6):263‐8. [MEDLINE: ] - PubMed
Wiener 2007
    1. Wiener RS, Welch HG. Trends in the use of the pulmonary artery catheter in the United States, 1993‐2004. JAMA 2007;298(4):423‐9. [MEDLINE: ] - PubMed
Zion 1990
    1. Zion MM, Balkin J, Rosenmann D, Goldbourt U, Reicher‐Reiss H, Kaplinsky E, et al. Use of pulmonary artery catheters in patients with acute myocardial infarction. Analysis of experience in 5,841 patients in the SPRINT Registry. SPRINT Study Group. Chest 1990;98(6):1331‐5. [MEDLINE: ] - PubMed

References to other published versions of this review

Harvey 2006
    1. Harvey S, Young D, Brampton W, Cooper A, Doig GS, Sibbald W, et al. Pulmonary artery catheters for adult patients in intensive care. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD003408.pub2] - DOI - PubMed

Publication types