Clinical assessment of hemodynamic values in two surgical intensive care units. Effects on therapy
G. Celoria, J. S. Steingrub, M. Vickers-Lahti, D. Teres, K. L. Stein, M. Fink and P. Friedmann
Department of Surgery, Baystate Medical Center, Springfield, Mass. 01199.
A prospective study of 126 surgical patients from two institutions was
undertaken to assess the impact of pulmonary artery catheterization in
surgical intensive care units. Before catheterization, surgical residents
were asked to predict pulmonary artery wedge pressure, cardiac output,
systemic vascular resistance, and plan of therapy. After catheterization,
each chart was reviewed by a panel of intensive care specialists and a
general surgeon. Correct classification for the hemodynamic variables
ranged from 47% to 55%. Catheterization results prompted a major change in
therapy in 50% of patients. The data suggest that hemodynamic variables
obtained from pulmonary artery catheterization improve the accuracy of
bedside evaluation and lead to alteration in therapy, particularly in
patients whose pulmonary artery wedge pressure predictions were poor.
