The Swan-Ganz Catheters: Past, Present, and Future A Viewpoint
The Swan-Ganz Catheters: Past, Present, and Future A Viewpoint
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DOI：
10.1161/circulationaha.108.811141
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发表时间：
2009-01-06
期刊：
影响因子：
37.8
通讯作者：
Chatterjee, Kanu
中科院分区：
文献类型：
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作者：
Chatterjee, Kanu
Swan-Ganz球囊漂浮导管于1970年推出。它可以在几分钟内放置在床边，即使是重症患者。虽然这些导管的放置并不困难，但需要一些培训和经验，以避免并发症，并正确解释肺动脉导管插入术可获得的血流动力学数据。由于球囊漂浮导管与传统导管相比具有许多优点，因此在没有适当适应症的情况下使用球囊漂浮导管，并且在重症监护室中经常过度使用球囊漂浮导管，导致许多并发症，包括死亡。前瞻性随机试验报告称，在大多数临床情况下，球囊漂浮导管不适用于常规使用。这些结果并不令人惊讶，因为球囊漂浮导管是诊断工具而不是治疗工具。我们已经了解了很多关于危重患者使用球囊漂浮导管的血流动力学，这不应该被忽视或忘记。此外，我们的血流动力学的临床知识已经成为可能，因为广泛的经验，直接确定血流动力学与使用球囊漂浮导管。还应该认识到，尽管引入和改进了较新的无创成像模式，但存在许多临床情况，其中必须使用球囊漂浮导管确定血流动力学，并且应该考虑，但只能由有经验的医生进行。随着Swan-Ganz导管的正确使用，我们对血流动力学的了解大大提高。滥用，特别是由相对缺乏经验的操作者滥用，导致严重的并发症，包括死亡。前瞻性随机临床试验表明，常规使用Swan-Ganz导管不会带来任何益处。然而，Swan-Ganz导管仍适用于许多情况。（循环。2009; 119：147-152）。
The Swan-Ganz balloon flotation catheter was introduced in 1970. It can be placed at the bedside within a few minutes even in critically ill patients. Although placement of these catheters is not difficult, some training and experience are required to avoid complications and for proper interpretation of the hemodynamic data that can be obtained by pulmonary artery catheterization. Because of the many advantages of balloon flotation catheters compared with conventional catheters, they have been used without a proper indication and frequently overused in critical care units, resulting in many complications, including mortality. The prospective randomized trials have reported that in the majority of clinical circumstances, the routine use of balloon flotation catheters is not indicated. These results are not surprising because balloon flotation catheters are diagnostic and not therapeutic tools. That we have learned a great deal about hemodynamics in critically ill patients with the use of balloon flotation catheters should not be ignored or forgotten. Furthermore, our clinical knowledge of hemodynamics has been made possible because of extensive experience gained from directly determined hemodynamics with the use of balloon flotation catheters. It should also be realized that despite the introduction and refinement of newer noninvasive imaging modalities, a number of clinical circumstances exist in which determination of hemodynamics with the use of a balloon flotation catheter is necessary and should be considered, but only by experienced physicians. With the proper use of Swan-Ganz catheters, our knowledge of hemodynamics has been enhanced considerably. Its abuse, particularly by relatively inexperienced operators, has resulted in serious complications, including death. Prospective randomized clinical trials have demonstrated that the routine use of Swan-Ganz catheters does not provide any benefit. However, use of the Swan-Ganz catheter is still indicated in many situations. (Circulation. 2009; 119: 147-152.)