Evaluation of Right-Heart Catheterization in the Critically Ill Patient without Acute Myocardial Infarction
Abstract
FLOW-directed right-heart catheterization is used extensively to monitor the hemodynamic status of critically ill patients. After acute myocardial infarction, measurements of the cardiac index and pulmonary capillary wedge pressure are useful in several ways: they allow accurate assessment of short-term and long-term prognosis,1 help in directing immediate and subsequent therapy,2 3 4 and correlate well with the clinical assessment of the hemodynamic status.5 Although there is no evidence that right-heart catheterization reduces the mortality of patients with acute myocardial infarction,6 the information it yields is sufficiently useful in assessing prognosis and directing therapy that the risks associated with catheterization7 , 8 are thought to . . .
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Estimations of cardiac function, cardiac output, and tissue oxygenation based on standard clinical parameters such as physical examination, central venous pressure, heart rate, and blood pressure are often discordant from measured values.
“It is important to appreciate that estimations of cardiac function, cardiac output and tissue oxygenation, based on the interpretation of standard clinical parameters, such as the physical examination, and hemodynamic parameters such as the central venous pressure, heart rate and blood pressure are often discordant from measured values [7, 8].”
From Management of the Low Cardiac Output Syndrome Following Surgery for Congenital Heart Disease (2016) · cites this paper as [7]
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“It is important to appreciate that estimations of cardiac function, cardiac output and tissue oxygenation, based on the interpretation of standard clinical parameters, such as the physical examination, and hemodynamic parameters such as the central venous pressure, heart rate and blood pressure are often discordant fr…”
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“assessment but has been shown to be occasionally inaccurate [4-6].”
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“The use of the PAC begun to decrease after publication of observational data suggesting an increased risk of death with PAC use in patients with [5] and without [6] acute myocardial infarction.”
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“(2), patients with PAC had an increased 30-day mortality with an odds ratio of 1.”
BackgroundInfluential
- Authors
- Connors, A. F., McCaffree, D. R., & Gray, B. A.
- Affiliations
- University of Oklahoma Health Sciences Center (US)
- ORCID
- Connors, Alfred F.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1983-02-03
- Volume
- 308
- Issue
- 5
- Pages
- 263-267
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2033283702
- Cited by
- 365
- References
- 0
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 6 · 2022: 7 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 5 · 2017: 7 · 2016: 12 · 2015: 2 · 2014: 5 · 2013: 8 · 2012: 5
- FWCI
- 23.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- right heart catheterization, hemodynamic monitoring, critically ill patients, acute myocardial infarction, cardiac index, pulmonary capillary wedge pressure, prognostic assessment
- MeSH terms
- Adolescent, Adult, Aged, Blood Pressure, Critical Care, Diagnostic Tests, Routine, Female, Cardiac Catheterization, Hemodynamics, Humans, Male, Middle Aged, Multiple Organ Failure, Pulmonary Wedge Pressure, Technology Assessment, Biomedical
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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