Pulmonary artery catheterisation.

The introduction of balloon-tipped pulmonary artery flotation catheters revolutionised monitoring of the cardiovascular system and the management of seriously ill patients. Advances in design allow direct measurement of cardiac output and continuous mixed venous oxygen saturation, while intracardiac electrocardiogram monitoring and passage of pacing wires is now possible. The technique of insertion must be meticulous as must the method of obtaining central venous, pulmonary artery, pulmonary artery wedge and pulmonary capillary wedge pressures. Sources of error are highlighted as are methods to avoid and detect them. Correct interpretation of the data is essential for proper patient management and must be taken in light of information obtained by other methods. Complications of insertion are numerous and potentially serious or even lethal. It is mandatory that the information obtained by insertion of a pulmonary artery catheter be used to optimize patient management.