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Volume 348:2035-2037 May 15, 2003 Number 20
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Pulmonary-Artery Catheters in High-Risk Surgical Patients

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 by Sandham, J. D.
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To the Editor: The study by Sandham et al. (Jan. 2 issue)1 showed no improvement in outcome resulting from goal-directed therapy guided by pulmonary-artery catheter in high-risk surgical patients. The main targets (an oxygen-delivery index of 550 to 600 ml per minute per square meter of body-surface area and a cardiac index of 3.5 to 4.5 liters per minute per square meter) were reached by only about 20 percent of the patients preoperatively and by less than 80 percent during the postoperative period. However, trials that showed a benefit with this strategy have suggested that hemodynamic optimization has to be . . . [Full Text of this Article]


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