Pulmonary artery catheterization and mortality in critically ill patients

Pulmonary artery catheters are widely used in intensive care,but evidence to support their widespread use is sparse. Somepublished data suggest that greater mortality is associatedwith use of these catheters. The largest study to date lookedat >5500 patients in several centres in America and founda greater 30 day mortality in those patients receiving a pulmonaryartery catheter. We tested the hypothesis that, on our intensivecare unit, mortality was greater for those patients receivinga pulmonary artery catheter. Using a propensity score to accountfor severity of illness, the odds ratio for mortality in thosepatients receiving a pulmonary artery catheter was 1.08 (95%confidence interval 0.87–1.33). We believe that continueduse of the pulmonary artery catheter is safe; a large randomizedcontrolled trial examining outcome is unlikely to provide anadequate answer. Br J Anaesth 2000; 85: 611–5 ^* Corresponding author