The recently completed Fluid and Catheter Treatment Trial conducted by the National Institutes of Health ARDSNetwork casts doubt on the value of routine pulmonary artery catheterization for hemodynamic management of the critically ill. Several alternatives are available, and, in this review, we evaluate the theoretical, validation, and empirical databases for two of these: transpulmonary thermo...

669 September 2015 A the overall pulmonary artery catheter (PAC) use has decreased, it remains a valuable tool in select patients. PAC insertion may result in ventricular or supraventricular dysrhythmias due to contact of the catheter with the cardiac chamber walls. The use of balloon-tipped catheters during insertion serves to increase the catheter tip surface area, thereby mitigating applied ...

A 10-year old girl underwent a CT angiogram to investigate right lung hypoplasia. This showed a normal bronchial tree, lung parenchyma and pulmonary venous drainage, but an absent right pulmonary artery. Cardiac catheterization with pulmonary vein wedge injections identified a disconnected hypoplastic right pulmonary artery system supplied by an occluded right-sided ductus arteriosus. Transcath...

The birth of the intermittent injectate-based conventional pulmonary artery catheter (fondly nicknamed PAC) was proudly announced in the New England Journal of Medicine in 1970 by his parents HJ Swan and William Ganz. PAC grew rapidly, reaching manhood in 1986 where, in the US, he was shown to influence the management of over 40% of all ICU patients. His reputation, however, was tarnished in 19...

Introduction of a cardiac catheter into the pulmonary artery from the right heart is not possible in a substantial proportion of patients with transposition of the great vessels. It is necessary to obtain the pulmonary artery pressure and oxygen saturation value to evaluate the degree of pulmonary stenosis and the pulmonary vascular resistance. Twenty-three patients are described in whom this w...

The contour of the pulmonary artery wedge pressure tracing in a case of pulmonary venous obstruction was unique and may be diagnostic. Wedged pressures were obtained in both a pulmonary artery and a pulmonary vein on recatheterization of a 5-yearold boy with total anomalous pulmonary venous drainage to the superior vena cava on whom an anastomosis of the confluence of the pulmonary veins to the...

T he ability to measure the hydrostatic pressure in a capillary bed (Pc) was an impetus for the development of the arterial occlusion method [1]. The relevance of Pc in pulmonary circulation is its role in pulmonary oedema formation. In order to accurately measure Pc, the isogravimetric method and the double occlusion technique have served as standards [2, 3]. However, both techniques require s...