RT Book, Section
A1 Neuman, J. Elizabeth
A1 Mann, Jessica
A2 Reichman, Eric F.
SR Print(0)
ID 1159798402
T1 Pulmonary Artery (Swan-Ganz) Catheterization
T2 Reichman's Emergency Medicine Procedures, 3e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259861925
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1159798402
RD 2024/04/23
AB The  concept  of  invasive  hemodynamic  monitoring  was  first  pioneered  in  the  mid-1800s.  After  that  time,  various  devices  and  techniques  evolved  until  Swan  and  Ganz  developed  the  balloon-tipped  pulmonary  artery  catheter  (PAC)  in  1970.1-3  The  “Swan-Ganz  catheter”  has  been  used  almost  exclusively  in  the  intensive  care  setting  ever  since,  with  an  estimated  1  million  PACs  placed  annually  at  a  cost  of  approximately  2  billion  dollars.4,5  The  use  of  the  PAC  has  allowed  clinicians  to  measure  right  atrial,  pulmonary  artery,  and  pulmonary  capillary  wedge  pressures  at  the  bedside.6  Although  advanced  hemodynamic  monitoring  would  seem  intuitively  to  help  clinicians  in  the  management  of  unstable  patients,  the  PAC  has  not  been  found  to  improve  survival,  and  its  use  has  declined  significantly  over  the  past  20  years.7  While  the  utility  of  the  PAC  has  become  less  clear,  particularly  with  advances  in  less  invasive  monitoring  techniques,  it  is  still  used  in  complex  cases.8  This  chapter  focuses  on  the  actual  technique  of  placement  of  the  PAC  and  is  predicated  on  the  ability  of  the  Emergency  Physician  (EP)  to  gain  central  venous  access  (Chapters  63  and  64).