|
In medicine pulmonary artery catheterization (PAC) is the insertion of a catheter into a pulmonary artery. Its purpose is diagnostic; it is used to detect heart failure or sepsis, monitor therapy, and evaluate the effects of drugs. The pulmonary artery catheter allows direct, simultaneous measurement of pressures in the right atrium, right ventricle, pulmonary artery, and the filling pressure ("wedge" pressure) of the left atrium. The pulmonary artery catheter is frequently referred to as a Swan-Ganz catheter, in honor of its inventors Jeremy Swan and William Ganz, from Cedars-Sinai Medical Center. The idea for a sail or balloon tip modification of Ronald Bradley's simple portex tubing method came about from Swan's observation from the Laguna Beach CA shore of sail boats on the water on a relatively calm day. Boats with conventional slot sails were still; one with a spinnaker was able to make reasonable headway. The concept of using thermodilution to measure cardiac output was originally the idea of Arnost Fronek. As a former colleague of Fronek, Ganz added the thermistor modification after Swan showed him the initial balloon design, which was fabricated by Edwards Laboratories, which had previously contracted with Swan as a consultant. ==Indications== General indications are: *Management of complicated myocardial infarction * *Hypovolemia vs cardiogenic shock * *Ventricular septal rupture (VSR) vs acute mitral regurgitation * *Severe left ventricular failure * *Right ventricular infarction * *Unstable angina * *Refractory ventricular tachycardia *Assessment of respiratory distress * *Cardiogenic vs non-cardiogenic pulmonary edema * *Primary vs secondary pulmonary hypertension *Assessment of type of shock *Assessment of therapy * *Afterload reduction * *Vasopressors * *Beta blockers * *Intra-aortic balloon counter-pulsation *Assessment of fluid requirement in critically ill patients * *Hemorrhage * *Sepsis * *Acute renal failure aka Acute Kidney Injury * *Burns *Management of postoperative open heart surgical patients *Assessment of valvular heart disease *Assessment of cardiac tamponade/constriction No study has definitively demonstrated improved outcome in critically ill patients managed with PA catheters. Therefore, the primary justification has been on the basis of clinic experience. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Pulmonary artery catheter」の詳細全文を読む スポンサード リンク
|