Stellenwert des intensivmedizinischen Monitoring mit dem Pulmonararterienkatheter

Pulmonary artery catheterization (PAC) is widely used for monitoring and optimization of hemodynamic therapy in critically ill patients. Despite its widespread use there is no clear evidence that morbidity and mortality can be reduced by this approach. In contrast, it has been suggested that PAC might increase mortality. Available data do not allow the definitive omission of PAC in medical intensive care, nor do they justify its widespread use. Possible reasons that might affect outcome are catheter-related complications and often misinterpretation due to insufficient knowledge about PAC. Open questions on the influence of PAC on outcome variables in critically ill patients have to be answered by conducting randomized controlled trials. Beforehand, knowledge about PAC has to be improved. As a consequence, PAC should be performed whenever a specific hemodynamic question arises that cannot be answered by clinical judgement or by less invasive means. It is important that the investigator be experienced in catheter placement and data interpretation to avoid harm to these critically ill patients.