Table 2.
A comparison of the pulmonary artery catheter and the central venous cathetera
| Parameter | PAC | Central Venous Catheter | Relative Accuracy of Each Parameter |
|---|---|---|---|
| Obtainable measurements | |||
| SvO2 | + | − | ++ |
| CO | + | − | ++ |
| intrapulmonary vascular pressures (pulmonary artery systolic and pulmonary artery diastolic) | + | − | ++ |
| preload variable, PaOP | + | − | − |
| preload variable, CVP | + | + | − |
| ScvO2 | + | + | + |
| continuous ScvO2b | + | + | + |
| Adverse effects | Incidence (%) | ||
| thrombosisb | + | + | 2 to 67 |
| pneumothorax | + | + | 0.3 to 3.0 |
| arterial puncture | + | + | 1.1 to 1.3 |
| hematoma or hemorrhage | + | + | 1 to 5 |
| vascular infection | + | + | 0.7 to 11.4 |
| arrhythmias | + | + | |
| minor dysrhythmias | + | + | 4.7 to 68.9 |
| severe dysrhythmias | + | − | 0.3 to 62.7 |
| right bundle brand block | + | − | 0.1 to 4.3 |
| complete heart block | + | − | 0.05 to 5.00 |
| catheter fragment or knots | + | − | <1 |
| pulmonary infarct | + | − | <1 |
| pulmonary rupture | + | − | 0.1 to 1.5 |
| Can be used outside the ICU (regular medical or surgical floor) | − | + | |
| Costc | ++ | + |
a
CO, cardiac output; CVP, central venous pressure; ICU, intensive care unit; PAC, pulmonary artery catheter; PaOP, pulmonary artery occlusion pressure; ScvO2, central venous saturation; SvO2, mixed venous oxygen saturation
b
Incidence varies depending on location (femoral versus subclavian) and duration of the catheter. Many thromboses are discovered on postmortem evaluation and are not clinically relevant (29).
c
A meta-analysis of five trials demonstrated that costs were higher for patients who were treated using PAC compared with those without PAC. One study showed that the cost per quality-adjusted life year gained from withdrawing a PAC was $5672(31,32).