Pulmonary artery catheters should be banned from intensive care units

BMJ 1996;313:1328 (23 November)

Letters

Pulmonary artery catheters should be banned from intensive care units

EDITOR,--I congratulate Neil Soni on his controversial editorialquestioning the value of pulmonary artery catheterisation.¹I have long been deeply cynical about the value of pulmonaryartery catheters in critically ill patients. While they undoubtedlyprovide fascinating physiological data, there is no evidencethat they play any part in reducing mortality.

In the intensive care unit at this hospital pulmonary arterycatheters are associated with a 92% mortality. This does notmean that they actually cause death, since we reserve them forour illest patients, who have a high risk of death in any event,but it suggests that they are seldom of benefit to the patients.

It is hard to prove that pulmonary artery catheters have a negativeimpact on patients' survival despite the recent paper by Connorset al.² It is easy, though, to postulate two mechanisms by whichpulmonary artery catheters may tip the balance between life. . . [Full text of this article]

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