tailieunhanh - Báo cáo khoa học: "The pulmonary artery catheter: the tool versus treatments based on the tool"

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: The pulmonary artery catheter: the tool versus treatments based on the tool. | Available online http content 10 4 162 Commentary The pulmonary artery catheter the tool versus treatments based on the tool Jukka Takala Clinic of Intensive Care Medicine University Hospital Bern CH-3010 Bern Switzerland Corresponding author Jukka Takala Published 31 August 2006 This article is online at http content 10 4 162 2006 BioMed Central Ltd Critical Care 2006 10 162 doi cc5021 Abstract The pulmonary artery catheter PAC is a powerful tool that has been used extensively in the assessment and monitoring of cardiovascular physiology. Gross misinterpretation of data gathered by the PAC is common and its routine use without any specific interventions has not been shown to influence outcome. However there currently is no evidence from randomized controlled trials that any diagnostic or monitoring tool used in intensive care patients improves outcome. Studies evaluating the use of the PAC have included numerous potential confounding factors and should be interpreted with caution. The information obtained with the PAC should be used to find better treatment strategies and these strategies instead of the tool itself should be tested in clinical trials. The pulmonary artery catheter is a diagnostic and monitoring tool. The ongoing debate over the use of pulmonary artery catheters is focused on their impact on outcome. The value of any diagnostic tool in improving outcome depends first on its ability to correctly diagnose the disorders it is meant to diagnose second on the relevance of such disorders to the outcome of interest and third on the availability of treatment to correct the diagnosed disorders. The value of clinical monitoring tools goes somewhat further. The rationale for using clinical monitoring tools can be based as well on prevention of disorders that if allowed to develop can have relevant effects on outcome. Do we have evidence from randomized controlled trials that any diagnostic tool per se .

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