Right heart catheterization in acute respiratory failure.

Objective: To review the literature addressing the use of the pulmonary artery catheter (PAC) in patients with respiratory failure.

Data source: All pertinent English language articles dealing with pulmonary artery catheterization in patients with respiratory failure were retrieved from 1983 through 1996.

Study selection: Articles were chosen for review if the use of pulmonary artery catheterization in patients with respiratory failure was studied or reviewed.

Data extraction: From the articles selected, information was obtained about changes in therapy and changes in outcome associated with PAC use in patients with respiratory failure.

Data synthesis: Evidence exists to suggest that use of the PAC in patients with respiratory failure often results in a change in diagnosis and therapy. Inadequate evidence exists to accurately determine benefit or harm from PAC use in patients with respiratory failure.

Conclusion: The optimal role of the PAC as a diagnostic and monitoring device in different types of respiratory failure has not been clearly defined. Research is needed to determine the role of the PAC in very carefully defined groups of patients with respiratory failure.