scholarly journals Best evidence in anesthetic practice Goal-directed therapy with the pulmonary artery catheter is not better than standard therapy

2003 ◽  
Vol 50 (6) ◽  
pp. 614-616 ◽  
Author(s):  
Greg L. Bryson ◽  
Homer Yang
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Standard Therapy ◽  
Goal Directed Therapy ◽  
Anesthetic Practice ◽  
Better Than

scholarly journals Comparison of Goal-Directed Hemodynamic Optimization Using Pulmonary Artery Catheter and Transpulmonary Thermodilution in Combined Valve Repair: A Randomized Clinical Trial

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Andrey I. Lenkin ◽  
Mikhail Y. Kirov ◽  
Vsevolod V. Kuzkov ◽  
Konstantin V. Paromov ◽  
Alexey A. Smetkin ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Oxygen Transport ◽  
Transpulmonary Thermodilution ◽  
Stroke Volume Index ◽  
Pulmonary Artery Occlusion Pressure ◽  
Valve Surgery ◽  
Volume Index ◽  
Lung Water ◽  
Goal Directed Therapy

Our aim was to compare the effects of goal-directed therapy guided either by pulmonary artery catheter (PAC) or by transpulmonary thermodilution (TTD) combined with monitoring of oxygen transport on perioperative hemodynamics and outcome after complex elective valve surgery.Measurements and Main Results. Forty patients were randomized into two equal groups: a PAC group and a TTD group. In the PAC group, therapy was guided by mean arterial pressure (MAP), cardiac index (CI) and pulmonary artery occlusion pressure (PAOP), whereas in the TTD group we additionally used global end-diastolic volume index (GEDVI), extravascular lung water index (EVLWI), and oxygen delivery index (DO2I). We observed a gradual increase in GEDVI, whereas EVLWI and PAOP decreased by 20–30% postoperatively (P<0.05). The TTD group received 20% more fluid accompanied by increased stroke volume index and DO2I by 15–20% compared to the PAC group (P<0.05). Duration of mechanical ventilation was increased by 5.2 hrs in the PAC group (P=0.04).Conclusions. As compared to the PAC-guided algorithm, goal-directed therapy based on transpulmonary thermodilution and oxygen transport increases the volume of fluid therapy, improves hemodynamics and DO2I, and reduces the duration of respiratory support after complex valve surgery.

scholarly journals Cephalad misplacement of a pulmonary artery catheter in a patient with a preexisting Hickman catheter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hoon Choi ◽  
Joon Pyo Jeon ◽  
Jaewon Huh ◽  
Youme Kim ◽  
Wonjung Hwang
Keyword(s):  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Case Reports ◽  
Mitral Valve Regurgitation ◽  
Catheter Insertion ◽  
Routine Practice ◽  
Hickman Catheter ◽  
Risk Patients ◽  
The Right

Abstract Background Pulmonary artery catheter insertion is a routine practice in high-risk patients undergoing cardiac surgery. However, pulmonary artery catheter insertion is associated with numerous complications that can be devastating to the patient. Incorrect placement is an overlooked complication with few case reports to date. Case presentation An 18-year-old male patient underwent elective mitral valve replacement due to severe mitral valve regurgitation. The patient had a history of synovial sarcoma, and Hickman catheter had been inserted in the right internal jugular vein for systemic chemotherapy. We made multiple attempts to position the pulmonary artery catheter in the correct position but failed. A chest radiography revealed that the pulmonary artery catheter was bent and pointed in the cephalad direction. Removal of the pulmonary artery catheter was successful, and the patient was discharged 10 days after the surgery without complications. Conclusions To prevent misplacement of the PAC, clinicians should be aware of multiple risk factors in difficult PAC placement, and be prepared to utilize adjunctive methods, such as TEE and fluoroscopy.

scholarly journals Analysis of difficulty in placement of pulmonary artery catheter through the left internal jugular vein

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Akiko Tomita ◽  
Shoko Takada ◽  
Tomoko Fujimoto ◽  
Mitsuo Iwasaki ◽  
Yukio Hayashi
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Left Internal Jugular Vein
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