Hemodynamic changes play a central role in the critically ill patient, so that monitoring of the circulation allows evaluation of the etiology, severity, and course of circulatory instability and its response to treatment, supplementing clinical judgment. The pulmonary artery catheter allows a number of continuous and intermittent measurements to be made from which other variables can be derived (Table.!). However, the relevance of these variables to treatment and prognosis is difficult to prove. In addition, interpretation of the data may be difficult, so that additional bedside imaging techniques may be required. Therefore doubts have been expressed as to whether the benefits of a pulmonary artery catheter outweigh the risks of insertion and whether its use improves outcome. Nevertheless, the catheter may allow evaluation of responses to therapy and assessment of physiological and perhaps prognostically important endpoints for resuscitation, supplementing the clinical indicators of circulatory instability.
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