Overuse and abuse of Swan-Ganz catheters. 1987

E D Robin

The widespread use of the Swan-Ganz catheter is a result of a general misconception. It is widely accepted that the collection of data is a way of practicing scientific medicine. That is simply not true. The data must on balance contribute to a better outcome for patients as established by a scientific trial. The present widescale use of the catheter provides a striking example of the misuse or even mindless use of technology. Because of a tenuous risk-benefit balance, it is not at all certain that the general use of the Swan-Ganz catheter is justifiable and its use at best is semi-scientific. A reasonable approach would be to suspend its use pending an appropriate clinical trial which established safety and efficacy. Although the prospects for a clinical trial are bright, the prospects for a moratorium are not at all bright. While awaiting the results of an appropriate trial, individual physicians should only use the catheter when the probability is high that the data obtained by its use will provide more effective decision making. Such an approach by itself should result in a near-moratorium. Its present use is not a form of scientific medicine but at best a form of semi-scientific clinical practice.

UI MeSH Term Description Entries
D008991 Monitoring, Physiologic The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine. Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D011651 Pulmonary Artery The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. Arteries, Pulmonary,Artery, Pulmonary,Pulmonary Arteries
D002408 Catheters, Indwelling Catheters designed to be left within an organ or passage for an extended period of time. Implantable Catheters,In-Dwelling Catheters,Catheter, In-Dwelling,Catheter, Indwelling,Catheters, In-Dwelling,In Dwelling Catheters,In-Dwelling Catheter,Indwelling Catheter,Indwelling Catheters
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012449 Safety Freedom from exposure to danger and protection from the occurrence or risk of injury or loss. It suggests optimal precautions in the workplace, on the street, in the home, etc., and includes personal safety as well as the safety of property. Safeties

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