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. Some published data suggest that greater mortality is associated with use of these catheters. The largest s tudy to date looked at >5500 patients in several centres in America and fou nd a greater 30 day mortality in those patients receiving a pulmonary arter y catheter. We tested the hypothesis that, on our intensive care unit, mort ality was greater for those patients receiving a pulmonary artery catheter. Using a propensity score to account for severity of illness, the odds rati o for mortality in those patients receiving a pulmonary artery catheter was 1.08 (95% confidence interval 0.87-1.33). We believe that continued use of the pulmonary artery catheter is safe; a large randomized controlled trial examining outcome is unlikely to provide an adequate answer.