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I agree with Dr Sharkey that our recommendation that the FDA issue a moratorium on the use of flow-directed PA catheters if an appropriately designed multicenter randomized controlled clinical trial of the use of PA catherization is not undertaken was a hard-line position.
The statement by Dr Hoyt that the SCCM understands that it was our intent to stimulate the National Heart, Lung, and Blood Institute to undertake an appropriate randomized clinical trial is correct.
It would appear from the response of the American College of Chest Physicians, the American College of Cardiology, and the Society of Critical Care Medicine that such a trial will be undertaken. It will be a very difficult and challenging trial. I hope that the trial will identify which subgroups of critically ill patients benefit from PA catherization and which subgroups do not.
Dalen JE. Effectiveness of Right Heart Catheterization: Time for a Randomized Trial. JAMA. 1997;277(2):114. doi:10.1001/jama.1997.03540260028029