ABSTRACT
Balloon-tipped pulmonary artery (PA) catheters have come into widespread use since their inception in the early 1970s (1). On average, 16.1% of patients in U.S. intensive care units (ICUs) have PA catheters at some time during their ICU stay (range <0.1% to 40.5% for patients in neonatal and surgical ICUs, respectively (2)). More than one million PA catheters are sold in the United States each year and the annual cost associated with their use exceeds $2 billion per year (3). Nevertheless, controversy surrounds the utility and safety of this device. An uncontrolled, observational study suggested that PA catheter use was associated with increased mortality and cost (4). This finding prompted a consensus conference, which suggested that based on the available literature, use of PA catheters improves outcomes in many clinical
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scenarios; however, uncertainty remains in its use for many conditions. The complex and unique features of the PA catheter present challenges to the user of this device unlike any other catheter used in caring for critically ill patients (5). Not surprisingly, the consensus panel suggested that clinician knowledge about PA catheter use and complications needs to be improved upon (6). More recently, a meta-analysis of randomized, controlled trials revealed that PA catheter-guided strategies to care for patients led to a significant reduction in morbidity (7).
