Pulmonary artery catheters in sepsis/septic shock.

OBJECTIVE: To review the literature addressing use of the pulmonary artery catheter (PAC) in patients with sepsis and septic shock. DATA SOURCE: All pertinent English language articles dealing with the use of pulmonary artery catheterization in patients with sepsis and septic shock were retrieved from 1984 through 1996. STUDY SELECTION: Articles were chosen for review if the use of pulmonary artery catheterization in patients with sepsis/septic shock 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 sepsis/septic shock. DATA SYNTHESIS: Inadequate evidence exists to accurately determine if PAC use improves outcome in patients with sepsis/septic shock. Attempting to achieve supranormal hemodynamic variables in patients with septic shock is not warranted. CONCLUSION: Based largely upon expert opinion, PAC use may be appropriate in patients with septic shock unresponsive to early resuscitative measures. Maintenance of normal hemodynamics in this group of patients appears to be the appropriate goal. Research is needed to determine the proper role of the PAC in patients with sepsis/septic shock.