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January 8, 1997

Effectiveness of Right Heart Catheterization: Time for a Randomized Trial

Author Affiliations

The Long Island College Hospital Brooklyn, NY

JAMA. 1997;277(2):111. doi:10.1001/jama.1997.03540260025021

To the Editor.  —The findings reported by Dr Connors et al1 did not come as a surprise to the physicians at the Long Island College Hospital. In 1994, we presented our own findings at the Clinical Research Meetings2 in which we came to similar conclusions. At least in part based on those findings, physicians at our hospital curtailed the use of the Swan-Ganz catheter. In 1978,I wrote an article3 demonstrating the lack of utility of RHC in patients having coronary angiography. However, until recently, this procedure was done routinely in many laboratories.The use of the Swan-Ganz catheter in critically ill individuals is based on 2 concepts: (1) the catheter provides information required for clinical management that cannot be obtained otherwise, and (2) by the use of such information a patient's cardiovascular status can be "optimized" to better tolerate various conditions. The first notion is rarely true, and the second

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