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Concept
Pulmonary artery catheter
Summary
A pulmonary artery catheter (PAC), also known as a Swan-Ganz catheter or right heart catheter, is a balloon-tipped catheter that is inserted into a pulmonary artery in a procedure known as pulmonary artery catheterization or right heart catheterization. Pulmonary artery catheterization is a useful measure of the overall function of the heart particularly in those with complications from heart failure, heart attack, arrythmias or pulmonary embolism. It is also a good measure for those needing intravenous fluid therapy, for instance post heart surgery, shock, and severe burns. The procedure can also be used to measure pressures in the heart chambers.
The pulmonary artery catheter allows direct, simultaneous measurement of pressures in the right atrium, right ventricle, pulmonary artery, and the filling pressure (pulmonary wedge pressure) of the left atrium. The pulmonary artery catheter is frequently referred to as a Swan-Ganz catheter, in honor of its inventors Jeremy Swan and William Ganz, from Cedars-Sinai Medical Center.
General indications are:
Management of complicated myocardial infarction
Hypovolemia vs cardiogenic shock
Ventricular septal rupture (VSR) vs acute mitral regurgitation
Severe left ventricular failure
Right ventricular infarction
Unstable angina
Refractory ventricular tachycardia
Assessment of respiratory distress
Cardiogenic vs non-cardiogenic pulmonary edema
Primary vs secondary pulmonary hypertension
Assessment of types of shock
Assessment of therapy
Afterload reduction
Vasopressors
Beta blockers
Intra-aortic balloon counter-pulsation
Assessment of fluid requirement in critically ill patients
Hemorrhage
Sepsis
Acute kidney injury
Burns
Management of postoperative open heart surgical patients
Assessment of valvular heart disease
Assessment of cardiac tamponade/constriction
No study has definitively demonstrated improved outcome in critically ill patients managed with PA catheters. Given that the PA catheter is a monitoring tool and not a therapy in and of itself this is not entirely surprising.
Official source
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