Pulmonary Arterial Catheterization – Use and Interpretation:
-Pulmonary arterial catheterization (PAC) has never been shown to improve patient-important outcomes.
-However, when the diagnosis or the type of shock remains undetermined or mixed, hemodynamic measurements obtained by PAC can be helpful
-Additional patients that may benefit from PAC are those with unknown volume status despite adequate fluid resuscitation, those with severe cardiogenic shock (eg, acute valvular disease), or those suspected to have severe underlying pulmonary artery hypertension or cardiac tamponade.
The major hemodynamic indices measured on PAC are
-cardiac output (ie, cardiac index)
-systemic vascular resistance
-pulmonary artery occlusion pressure (ie, pulmonary capillary wedge pressure)
-right atrial pressure
-mixed venous oxyhemoglobin saturation (SvO2).
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