Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (10)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Squara, P.
Right arrow Articles by Perret, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Squara, P.
Right arrow Articles by Perret, C.
(Chest. 2002;121:2009-2015.)
© 2002 American College of Chest Physicians

Pulmonary Artery Catheter*

Does the Problem Lie in the Users?

Pierre Squara, MD; David Bennett, MD and Claude Perret, MD

* From Réanimation polyvalente, Hôpital Victor Dupouy, Argenteuil, France.

Correspondence to: Pierre Squara, MD, Réanimation polyvalente, Hôpital Victor Dupouy, 69, rue du lieutenant Colonel Prudhon 95100, Argenteuil, France; e-mail: squarap{at}worldnet.fr

The aims of this study were to look for the variability in the treatment of circulatory shock and to assess the extent to which this variability was reduced by pulmonary artery catheterization (PAC). At three international conferences in 1997–1998 (European Society of Critical Care Medicine, French Language Society for Critical Care [Société de Réanimation de Langue Française], and Society of Critical Care Medicine), a real-life clinical case was discussed in meetings among physicians and a panel of experts, with assistance from an expert computer program. A total of 417 physicians took part in the discussions. Following the clinical presentation, only 38% of physicians suggested the same treatment as the experts, and 35% suggested potentially harmful treatments. Complete hemodynamic data from PAC significantly decreased the range of suggested treatments, improved agreement among physicians themselves as well as the agreement between physicians and experts, and decreased the number of potentially harmful propositions. However, whereas almost 80% of participants finally agreed on the treatment after one to three invasive hemodynamic sets of measurements, at least 10% persisted in suggesting potentially harmful treatments. PAC improved interphysician agreement, but our data suggest that yet greater agreement could be achieved by improving the theoretical training of practitioners.

Key Words: hemodynamics • medical intelligence • right-heart catheterization




This article has been cited by other articles:


Home page
 Canadian J. AnesthesiaHome page
G. L. Bryson and H. Yang
Best evidence in anesthetic practice: Goal-directed therapy with the pulmonary artery catheter is not better than standard therapy
Can J Anesth, June 1, 2003; 50(6): 614 - 616.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2002 by the American College of Chest Physicians.