Contents

Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Show Summary Details
Page of

Pulmonary artery catheterization in the ICU 

Pulmonary artery catheterization in the ICU
Chapter:
Pulmonary artery catheterization in the ICU
Author(s):

Efrat Orenbuch-Harroch

and Charles L. Sprung

DOI:
10.1093/med/9780199600830.003.0133
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2022. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 16 May 2022

Haemodynamic monitoring is a significant component in the management of critically-ill patients. Flow-directed pulmonary artery catheters (PAC) are a simple and rapid technique for measuring several continuous or intermittent circulatory variables. The PAC is helpful in diagnosis, guidance of therapy, and monitoring therapeutic interventions in various clinical conditions, including myocardial infarction and its complications, non-cardiogenic pulmonary oedema and severely ill patients.The catheter is inserted through a large vein. The PAC is advanced, after ballooninflation with 1.5 mL of air, through the right ventricle across the pulmonary valve and into the pulmonary artery (PA). Finally, the catheter is advanced to the ‘wedge’ position. The pulmonary artery wedge pressure (PAWP) is identified by a decrease in pressure combined with a characteristic change in the waveform. The balloon should then be deflated and the PA tracing should reappear. Direct measurements include central venous pressure, pulmonary artery pressure, and PAWP, which during diastole represents the left ventricular end-diastolic pressure and reflects left ventricular preload. Cardiac output can be measured by thermodilution technique. Other haemodynamic variables can be derived from these measurements. Absolute contraindications are rare. Relative contraindications include coagulopathy and conditions that increase the risk of arrhythmias.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.