Doctors should probably stop using pulmonary artery catheters because they do not benefit patients, say doctors from Australia in this week's BMJ.
The pulmonary artery catheter was invented in 1968. It enabled bedside monitoring in critically ill patients by measuring heart output and capillary pressure in the lungs and became widely used in intensive care units.
But reports of serious complications soon appeared and arguments for and against its use have continued ever since.
The most recent evaluation, commissioned by the NHS Health Technology Assessment (HTA) programme, found that pulmonary artery catheters do not benefit patients and concluded that withdrawing them from UK intensive care units would be cost effective.
Another recent trial in patients with acute lung injury confirmed these findings, while an analysis of 13 trials reported no overall effect of using these devices on mortality or length of hospital stay.
So what should clinicians do with all this information?
Given that the use of pulmonary artery catheters increases the risk of important complications, continued use of these devices is difficult to defend, say the authors.
The onus is now on the proponents of the pulmonary artery catheter and related devices to limit their use to clinical trials and to show that protocols based on such devices do benefit patients, they conclude.
Pulmonary artery catheters BMJ Volume 333 pp 930-1