Evaluation of Right-Heart Catheterization in the Critically Ill Patient without Acute Myocardial Infarction

Abstract

FLOW-directed right-heart catheterization is used extensively to monitor the hemodynamic status of critically ill patients. After acute myocardial infarction, measurements of the cardiac index and pulmonary capillary wedge pressure are useful in several ways: they allow accurate assessment of short-term and long-term prognosis,¹ help in directing immediate and subsequent therapy,^{2 3 4} and correlate well with the clinical assessment of the hemodynamic status.⁵ Although there is no evidence that right-heart catheterization reduces the mortality of patients with acute myocardial infarction,⁶ the information it yields is sufficiently useful in assessing prognosis and directing therapy that the risks associated with catheterization^{7 , 8} are thought to . . .