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June 5, 1981


JAMA. 1981;245(21):2182-2183. doi:10.1001/jama.1981.03310460034011

Steady scientific progress continues to be made on broad fronts in the specialty of anesthesiology. There are several that deserve highlighting and are presented here, not necessarily in order of their importance.

Invasive Monitoring  Invasive monitoring continues to receive substantial attention in the literature and at postgraduate symposia. The difficult question is when to monitor and, more specifically, when to monitor pulmonary capillary wedge pressures. Guidelines for use of balloon-tipped catheters were first suggested by Swan and Ganz1 in 1974. However, the topic continues to be debated heavily. One is struck with the wide spectrum of positions taken on this subject. Swan2 revealed his own bias by declaring central venous pressure (CVP) monitoring to be outmoded.Mangano,3 in admirable fashion, has recently made an effort to compare the CVP with the pulmonary capillary wedge pressure under varying conditions in a group of patients undergoing cardiopulmonary bypass. Simultaneous