AACN Practice Alert: Pulmonary Artery/Central Venous Pressure Monitoring in Adults

Pulmonary artery pressure (PAP), pulmonary artery occlusion pressure (PAOP), and central venous pressure (CVP) may aid in the differential diagnosis in pulmonary hypertension^1–4  and may be beneficial in complex shock states.⁵  Less invasive hemodynamic methods, in conjunction with the patient’s medical history, may also be useful in the differential diagnosis of cardiogenic shock.⁶ 

The appropriate use of pulmonary artery catheter (PAC)–guided therapy is associated with decreased mortality in patients with refractory heart failure/cardiogenic shock⁷  but is not associated with improved outcomes in patients with less severe heart failure. In trauma patients, PAC-guided therapy may benefit older, more severely injured patients, but use of a PAC is not associated with improved outcomes in other trauma populations.^8,9  Use of a PAC is not associated with improved outcomes in other populations, including high-risk cardiothoracic surgery¹⁰  and general intensive care unit (ICU) patients, although...