Proposed moratorium on use of pulmonary artery catheters is premature

BMJ 1996;313:1328 (23 November)

Letters

Proposed moratorium on use of pulmonary artery catheters is premature

EDITOR,--Neil Soni draws attention to an important study onthe apparent outcome of pulmonary artery catheterisation infive American teaching hospitals.¹ ² Some caution may need tobe used in interpreting the results of this paper, particularlyin relation to British practice.

More than one million pulmonary artery catheters are sold inthe United States each year; this equates to approximately 3.8/1000population. In Britain, use is less than a tenth of this figure.Connors et al chose nine disease categories to study²; theseincluded cirrhosis, metastatic colon cancer, and lung cancer,but patients with these diseases are highly unlikely to receiveaggressive intensive treatment in Britain. Furthermore, patientswith trauma, head injury, burns, and pregnancy were specificallyexcluded, and routine perioperative management of high risksurgical patients was not included despite evidence suggestingthat these patients benefit from pulmonary artery catheterisation.³Surgical patients were included in the study only . . . [Full text of this article]