Pulmonary artery catheter in paediatric care – therapeutical benefit or futility?

Overview

Aim:
To objectively assess if pulmonary artery catheterization is justified in defined paediatric critical care population subgroups.Design: Prospective observational study.Patients: Two subgroups of patients were enrolled in the study: 1) patients with severe refractory shock non-reactive to fluid resuscitation; 2) patientsmeeting criteria for ARDS.Method: We compared the results in time „0“ and after 24 hours after pulmonary artery catheter insertion.Measurements and parameters followed: Thermodilution pulmonary artery catheters Arrow 4F or 7F were used. The data were collected usingDatex AS/3 monitor. In patients with severe refractory shock we monitored CI, SVRI, PVRI, DO2, VO2, O2ER; in ARDS patients we monitored alsoPAPmean, and PCWP.Results: In all patients, hemodynamic monitoring led to changes in therapy, resulting in improvement of oxygen delivery and consumption. We didnot observe any complications neither during insertion of a catheter, nor during measurement.

Key words:
pulmonary artery catheter – hemodynamics – ARDS – shock