Sunday, June 14, 2009

Sunday June 14, 2009
On Swan-Ganz Catheter

Very important and precise article is written by Dr. Kanu Chatterjee, from the Chatterjee Center for Cardiac Research, University of California, San Francisco, on importance of The Swan-Ganz Catheters. Despite all it flaws and criticism, it remains an important and essential tool of hemodynamics.

Its an essential read for all intensivists.

"Pulmonary artery catheterization with the use of balloon flotation catheters is an easy and rapid technique for bedside hemodynamic monitoring. However, its abuse has been associated with complications that can be avoided if it is used by experienced operators. The randomized clinical trials in patients with acute coronary syndrome, noncoronary high-risk patients (including noncardiac surgical patients and patients with sepsis and ARDS), and patients with chronic heart failure have established that its routine use is not necessary and may be associated with increased complications, including death. However, it is still necessary in patients with cardiogenic shock, for the differential diagnosis of pulmonary arterial hypertension, and for diagnosis and treatment of uncommon causes and complications of heart failure. In patients with severe chronic heart failure requiring inotropic, vasopressor, and vasodilator therapy, hemodynamic monitoring is essential. For heart and lung transplantation workup, hemodynamic monitoring is always necessary. In many institutions, hemodynamic studies are conducted before liver transplantation".


Reference:

The Swan-Ganz Catheters: Past, Present, and Future - Circulation. 2009;119:147-152.

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