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CPT Masood A. Rajput, MC, USA; MAJ Harvey M. Richey, MC, USA; MAJ Bruce A. Bush, MC, USA; COL David L. Glendening, MC, USA; COL Joseph I. Matthews, MC, USA

Arch Intern Med. 1989;149(1):83-85.

Abstract
• Invasive hemodynamic monitoring is frequently required in the management of patients in intensive care units. A fiberoptic flow-directed thermal dilution pulmonary artery catheter capable of continuously monitoring the mixed venous saturation, while more expensive than a conventional pulmonary artery catheter, theoretically could result in better patient care, and might be cost-effective if it resulted either in fewer blood tests being ordered or in less time in the intensive care unit. To test this hypothesis, we designed a randomized trial in our Medical Intensive Care Unit to compare a standard pulmonary artery catheter with a fiberoptic catheter. Twenty-six patients received a standard catheter and 25 patients received the fiberoptic catheter. There were no statistical differences between the groups in age, time in the intensive care unit, number of tests ordered, hours of mechanical ventilator therapy, hours of vasoactive drug therapy, or mortality rate. The only statistically significant differences between the groups were that (1) the fiberoptic catheter required a longer insertion time and (2) there were more technical problems in consistently obtaining the wedge pressure in the patients with the fiberoptic catheters. We conclude that routine substitution of a fiberoptic catheter for the standard pulmonary artery catheter is not indicated.

(Arch Intern Med 1989;149:83-85)

Author Affiliations
From the Pulmonary Disease Service, Brooke Army Medical Center, San Antonio, Tex. Dr Rajput is now assigned to the 97th General Hospital, Frankfurt, West Germany. Dr Richey is now in private practice in San Antonio. Dr Glendening is now assigned to the Department of Emergency Medicine at Brooke Army Medical Center. Dr Matthews is now with the Department of Medicine, Fitzsimmons Army Medical Center, Aurora, Colo.

Footnotes
Accepted for publication July 21, 1988.

Presented at the 52nd meeting of the American College of Chest Physicians, San Francisco, Sept 24, 1986.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to the Department of Medicine, Fitzsimmons Army Medical Center, Aurora, CO 80045-5001 (Dr Matthews).

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