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September 18, 1996

Is It Time to Pull the Pulmonary Artery Catheter?

Author Affiliations

From the University of Arizona Health Sciences Center, Tucson (Dr Dalen). Dr Bone is Consulting Editor, JAMA.

JAMA. 1996;276(11):916-918. doi:10.1001/jama.1996.03540110070035

Pulmonary artery (PA) catheterization is performed daily in hospitals around the world. The hemodynamic data derived from PA catheterization are used to determine, monitor, and modify therapy in critically ill and/or hemodynamically unstable patients, including those with acute myocardial infarction (MI), congestive heart failure (CHF), and multiorgan failure, and they are frequently used to monitor patients with heart disease who undergo cardiac or noncardiac surgery. More than 1 million PA catheters are sold in the United States each year, and the annual costs associated with the use of PA catheters exceed $2 billion a year.

Despite the widespread use of this procedure and its attendant costs, there is no evidence that it benefits patients. Its use has not been shown to decrease patient morbidity or mortality. To the contrary, there is evidence that it may increase morbidity and mortality.

How Did We Get Here?  Pulmonary artery catheterization was first performed