Friday, May 14, 2010

Interpreting PA catheter tracings

This article from ACP hospitalist doesn't have much applicability for day to day practice because we infrequently use PA catheters now. I post it here because it rings so true to my experience of a couple of decades ago when we “Swanned” patients frequently. Measuring and recording hemodynamic variables with the PA catheter is not simple. It is a highly developed art. Measured and derived hemodynamic values must be understood physiologically and interpreted in light of clinical findings. Wedge pressure recordings must take into account the respiratory cycle. The fine points are explained in the article.

The principles of bedside right heart catheterization were sound, but I contend that relatively few physicians and critical care nurses recorded data correctly, whch is why research studies were negative and we finally pulled the catheter.

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