Pro: We Should Use a Pulmonary Artery Catheter with Right Ventricular Pressure Waveforms in Cardiac Surgical Patients

Abstract

Although pulmonary artery catheters (PAC) are used worldwide, their benefit is still a matter of debate. Recent studies have shown a survival benefit after cardiogenic shock in patients receiving a PAC. 1 Ranka S Mastoris I Kapur NK et al. Right heart catheterization in cardiogenic shock is associated with improved outcomes: Insights from the nationwide readmissions database. J Am Heart Assoc. 2021; 10e019843 Crossref Scopus (15) Google Scholar ,2 Chow JY Vadakken ME Whitlock RP et al. Pulmonary artery catheterization in patients with cardiogenic shock: A systematic review and meta-analysis. Can J Anesth. 2021; 68: 1611-1629 Crossref PubMed Scopus (9) Google Scholar However, as mentioned by Thiara et al., 3 Thiara S Griesdale DEG. The pulmonary artery catheter: A solution still looking for a problem. Can J Anesth. 2021; 68: 1592-1596 Crossref PubMed Scopus (1) Google Scholar it is unlikely that a randomized controlled trial will suffice to answer this question, first because of the complexity of patients in which this modality is used, and second because of the role individual competence plays in its successful use. In order to understand how to best select cardiac surgical patients in which to use PACs, the authors have proposed the following 4 questions.