British Journal of Anaesthesia, 2001, Vol. 86, No. 3 327-329
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia
Editorial |
Editorial I
Right heart catheterization in intensive care
On All Fools Day, 1949, the Journal of Applied Physiology received a manuscript from Hellems and colleagues describing the indirect measurement of left atrial pressure in man using occlusion of a small branch of the pulmonary artery.1 In the half century since this publication, the pulmonary artery wedge pressure has been used in the cardiac catheter laboratory by generations of cardiologists to diagnose and assess the severity of congenital and acquired cardiac disease and to appropriately select patients for surgical correction. Twenty-one years later, in 1970, Swan and colleagues described similar measurements made using a balloon-tipped flow-directed catheter.2 This development moved the right heart catheter out of the cardiac catheterization laboratory and up to the bedside. Continuous bedside monitoring of haemodynamic variables extended the scope of right heart catheterization beyond simple diagnosis, as manipulation of the various haemodynamic variables for presumed therapeutic benefit became a practical proposition. The best example
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