Consensus Conference on Pulmonary Artery Catheterisation.

The Consensus Conference on Pulmonary Artery Catheterisation ¹ attempted to answer the question of whether or not the use of a PAC improved patient outcomes in a variety of clinical situations. In addition to answering the questions, the quality of the evidence which supported the answer (Yes, No, or Uncertain) was also assessed.

A grade 'D' answer was supported by at least one randomised study using contemporaneous controls.

A grade 'E' answer was supported by case series, uncontrolled studies, and expert opinion. If controls were used, they were non-randomised or historical.

The full definition of the answer and evidence grades is shown in Table 1.

The conclusions drawn by this committee are shown in the table below:

Indication	Conclusion	Quality of evidence
Myocardial infarction with:
Hypotension or Cardiogenic Shock.	Yes	E
Mechanical Complication.	Yes	E
Right Ventricular Infarction.	Yes	E
Congestive Heart Failure.	Uncertain	D
Pulmonary Hypertension.	Uncertain	E
Haemodynamic Instability.	Uncertain	E
Cardiac Surgery:
Low risk Cardiac Surgery.	No	C
High risk Cardiac Surgery.	Uncertain	C
Peripheral Vascular Surgery:
Reduction in complications.	Yes	D
Reduction in morbidity.	Uncertain	D
Low risk Aortic Surgery.	Uncertain	B
High risk Aortic Surgery.	Yes	E
Other Indications:
Surgery in Geriatric Patients.	No	E
Neurosurgery.	Uncertain	E
Pre-eclampsia.	Not routinely	E
Trauma.	Yes	E
Sepsis / Septic shock.	Uncertain	D
Respiratory Failure.	Uncertain	E

References:

1. Pulmonary Artery Catheter Consensus conference: consensus statement. Crit Care Med 1997 Jun;25(6):910-25

Last edited on: 30/10/2000