Survey of Intensive Care Nurses’ Knowledge Relating to the Pulmonary Artery Catheter

Johnston, Ian; Jane, R.; Fraser, John F.; Krüger, Peter; Hickling, Keith G.

doi:10.1177/0310057x0403200415

Cited by 21 publications

(7 citation statements)

References 20 publications

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“…Johnson and colleagues using the same questionnaire as Iberti et al . in a cohort of ICU nurses demonstrated only 42% of questions were answered correctly [55]. In this study, 51% of respondents were unable to correctly identify the pressure change as the catheter was advanced from the right ventricle to the PA.…”

Section: Reviewmentioning

confidence: 64%

Obituary: pulmonary artery catheter 1970 to 2013

Marik

2013

Ann Intensive Care

153

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The birth of the intermittent injectate-based conventional pulmonary artery catheter (fondly nicknamed PAC) was proudly announced in the New England Journal of Medicine in 1970 by his parents HJ Swan and William Ganz. PAC grew rapidly, reaching manhood in 1986 where, in the US, he was shown to influence the management of over 40% of all ICU patients. His reputation, however, was tarnished in 1996 when Connors and colleagues suggested that he harmed patients. This was followed by randomized controlled trials demonstrating he was of little use. Furthermore, reports surfaced suggesting that he was unreliable and inaccurate. It also became clear that he was poorly understood and misinterpreted. Pretty soon after that, a posse of rivals (bedside echocardiography, pulse contour technology) moved into the neighborhood and claimed they could assess cardiac output more easily, less invasively and no less reliably. To make matter worse, dynamic assessment of fluid responsiveness (pulse pressure variation, stroke volume variation and leg raising) made a mockery of his ‘wedge’ pressure. While a handful of die-hard followers continued to promote his mission, the last few years of his existence were spent as a castaway until his death in 2013. His cousin (the continuous cardiac output PAC) continues to eke a living mostly in cardiac surgery patients who need central access anyway. This paper reviews the rise and fall of the conventional PAC.

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Section: Reviewmentioning

confidence: 64%

Obituary: pulmonary artery catheter 1970 to 2013

Marik

2013

Ann Intensive Care

153

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“…However, as suggested by numerous previous studies [3, 14, 17], this implies the need for major training to ensure the proper use of different techniques and the adequate interpretation of measured parameters to correctly guide therapeutic interventions. Our observation of a large use of diverse techniques suggests that it may be interesting to assess the clinical and cost effectiveness of each technique in the management of critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Haemodynamic Monitoring in the Intensive Care Unit: Results from a Web-Based Swiss Survey

Siegenthaler

Giraud

Saxer

et al. 2014

BioMed Research International

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Background. The aim of this survey was to describe, in a situation of growing availability of monitoring devices and parameters, the practices in haemodynamic monitoring at the bedside. Methods. We conducted a Web-based survey in Swiss adult ICUs (2009-2010). The questionnaire explored the kind of monitoring used and how the fluid management was addressed. Results. Our survey included 71% of Swiss ICUs. Echocardiography (95%), pulmonary artery catheter (PAC: 85%), and transpulmonary thermodilution (TPTD) (82%) were the most commonly used. TPTD and PAC were frequently both available, although TPTD was the preferred technique. Echocardiography was widely available (95%) but seems to be rarely performed by intensivists themselves. Guidelines for the management of fluid infusion were available in 45% of ICUs. For the prediction of fluid responsiveness, intensivists rely preferentially on dynamic indices or echocardiographic parameters, but static parameters, such as central venous pressure or pulmonary artery occlusion pressure, were still used. Conclusions. In most Swiss ICUs, multiple haemodynamic monitoring devices are available, although TPTD is most commonly used. Despite the usefulness of echocardiography and its large availability, it is not widely performed by Swiss intensivists themselves. Regarding fluid management, several parameters are used without a clear consensus for the optimal method.

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“…Beyond the medical indications for PAC use and nursing familiarity with the PAC, its setup and methodology for obtaining hemodynamic data remain a critical aspect of its use. Nursing scores on basic PAC fund of knowledge assessment tools among critical care nurses remain consistently low around the world (42.5%–56.8% correct answers) 31 – 33 . This is a result of their infrequent use.…”

Section: Central Venous Pressurementioning

confidence: 99%

Hemodynamic Monitoring in the Intensive Care Unit

et al. 2012

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Patients in the intensive care unit are often critically ill with inadequate tissue perfusion and oxygenation. This inadequate delivery of substrates at the cellular level is a common definition of shock. Hemodynamic monitoring is the observation of cardiovascular physiology. The purpose of hemodynamic monitoring is to identify abnormal physiology and intervene before complications, including organ failure and death, occur. The most common types of invasive hemodynamic monitors are central venous catheters, pulmonary artery catheters, and arterial pulse-wave analysis. Ultrasonography is a noninvasive alternative being used in intensive care units for hemodynamic measurements and assessments.

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Survey of Intensive Care Nurses’ Knowledge Relating to the Pulmonary Artery Catheter

Cited by 21 publications

References 20 publications

Obituary: pulmonary artery catheter 1970 to 2013

Obituary: pulmonary artery catheter 1970 to 2013

Haemodynamic Monitoring in the Intensive Care Unit: Results from a Web-Based Swiss Survey

Hemodynamic Monitoring in the Intensive Care Unit

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