The contemporary pulmonary artery catheter. Part 2: measurements, limitations, and clinical applications

J Clin Monit Comput. 2022 Feb;36(1):17-31. doi: 10.1007/s10877-021-00673-5. Epub 2021 Mar 1.

Abstract

Nowadays, the classical pulmonary artery catheter (PAC) has an almost 50-year-old history of its clinical use for hemodynamic monitoring. In recent years, the PAC evolved from a device that enabled intermittent cardiac output measurements in combination with static pressures to a monitoring tool that provides continuous data on cardiac output, oxygen supply and-demand balance, as well as right ventricular performance. In this review, which consists of two parts, we will introduce the difference between intermittent pulmonary artery thermodilution using bolus injections, and the contemporary PAC enabling continuous measurements by using a thermal filament which heats up the blood. In this second part, we will discuss in detail the measurements of the contemporary PAC, including continuous cardiac output measurement, right ventricular ejection fraction, end-diastolic volume index, and mixed venous oxygen saturation. Limitations of all of these measurements are highlighted as well. We conclude that thorough understanding of measurements obtained from the PAC is the first step in successful application of the PAC in daily clinical practice.

Keywords: Continuous cardiac output; Hemodynamic monitoring; Mixed venous oxygen saturation; Oxygen supply and -demand balance; Pulmonary artery catheter; Right ventricular ejection fraction; Right ventricular end-diastolic volume; Thermodilution.

Publication types

  • Review

MeSH terms

  • Cardiac Output
  • Catheterization, Swan-Ganz
  • Catheters
  • Humans
  • Middle Aged
  • Pulmonary Artery*
  • Stroke Volume
  • Thermodilution
  • Ventricular Function, Right*