tailieunhanh - Báo cáo y học: "Pulmonary artery catheters in acute heart failure: end of an era"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Pulmonary artery catheters in acute heart failure: end of an era. | Available online http content 13 6 1003 Commentary Pulmonary artery catheters in acute heart failure end of an era Christopher Vernon and Charles R Phillips Department of Medicine Division of Pulmonary and Critical Care 3181 SW Sam Jackson Park Road UHN-67 Oregon Health and Science University Portland OR 97239 USA Corresponding author Charles R Phillips phillipc@ Published 11 November 2009 This article is online at http content 13 6 1003 2009 BioMed Central Ltd Critical Care 2009 13 1003 doi cc8113 See related research by Ritter et al. http content 13 4 R133 Abstract Whereas the pulmonary artery catheter PAC is still widely used in guiding assessment and treatment of heart failure controversy surrounding its safety and efficacy has prompted development of newer less invasive techniques. For these purposes the transpulmonary thermodilution technique allows assessment of preload cardiac output filling volumes and metrics of contractility without the need to pass a catheter through the right heart. In a previous issue of Critical Care Ritter and colleagues compare metrics of transpulmonary thermodilution with the PAC in patients with acute heart failure and severe sepsis. The results add to a growing body of evidence that the PAC adds little to information attainable by less invasive methods in many conditions including acute heart failure. Whether newer devices improve outcome needs to be tested in well-controlled prospective trials. In a previous issue of Critical Care a comparison was made between metrics of transpulmonary thermodilution TPT and the pulmonary artery catheter PAC in patients with acute heart failure AHF and sepsis 1 . The results showed acceptable correlation between metrics derived from the two techniques and showed that TPT allowed identification of heart dysfunction in both heart failure and sepsis. This study while small and retrospective adds to mounting evidence that routine use of the PAC is