Skip to main content
Erschienen in: Intensivmedizin und Notfallmedizin 5/2010

01.06.2010 | Leitthema

Pulmonalarterienkatheter in der Anästhesiologie und operativen Intensivmedizin

Eine Bestandsaufnahme

verfasst von: Prof. Dr. M. Heringlake, H. Heinze

Erschienen in: Intensivmedizin und Notfallmedizin | Ausgabe 5/2010

Einloggen, um Zugang zu erhalten

Zusammenfassung

Angestoßen durch die Entwicklung alternativer Verfahren zur Bestimmung des Herzzeitvolumens, der zunehmenden Verbreitung der Echokardiographie und älterer, den Nutzen des Pulmonalarterienkatheters (PAK) beim Intensivpatienten infrage stellender Observationsstudien wird dieses Monitoringverfahren in den letzten Jahren zunehmend kritisch gesehen. Dies erscheint sowohl unter objektiver Betrachtung der Datenlage als auch unter Berücksichtigung der Tatsache, dass der PAK unverändert das umfassendste System zur kontinuierlichen Überwachung der kardialen Funktion und – bei sinnvoller Anwendung im Kontext einer zielgerichteten hämodynamischen Optimierung – eines der am besten nach Evidenzkriterien validierten anästhesiologisch-intensivmedizinischen Instrumente darstellt, nicht nachvollziehbar. Ziel der vorliegenden Arbeit ist es, einen Überblick über die methodischen Grundlagen des hämodynamischen Monitorings mittels PAK zu geben, die verfügbare Literatur zum Nutzen dieses Systems darzustellen, kritisch zu würdigen und Perspektiven für den Einsatz dieses Monitorings darzustellen.
Literatur
1.
Zurück zum Zitat Heringlake M, Heinze H, Misfeld M et al (2008) Goal-directed hemodynamic optimization in high-risk cardiac surgery patients: a tale from the past or a future obligation? Minerva Anestesiol 74:251–258PubMed Heringlake M, Heinze H, Misfeld M et al (2008) Goal-directed hemodynamic optimization in high-risk cardiac surgery patients: a tale from the past or a future obligation? Minerva Anestesiol 74:251–258PubMed
2.
Zurück zum Zitat Swan HJC, Ganz W, Forrester J et al (1070) Catheterazion of the heart in man with the use of a flow directed ballon catheter. N Engl J Med 283:447–451 Swan HJC, Ganz W, Forrester J et al (1070) Catheterazion of the heart in man with the use of a flow directed ballon catheter. N Engl J Med 283:447–451
3.
Zurück zum Zitat Shoemaker WC, Beez M (2010) Pathophysiology, monitoring, and therapy of shock with organ failure. Appl Cardiopulm Pathophysiol 14:30–38 Shoemaker WC, Beez M (2010) Pathophysiology, monitoring, and therapy of shock with organ failure. Appl Cardiopulm Pathophysiol 14:30–38
5.
Zurück zum Zitat Kohsaka S, Menon V, Lowe AM et al (2005) Systemic inflammatory response syndrome after acute myocardial infarction complicated by cardiogenic shock. Arch Intern Med 165:1643–1650CrossRefPubMed Kohsaka S, Menon V, Lowe AM et al (2005) Systemic inflammatory response syndrome after acute myocardial infarction complicated by cardiogenic shock. Arch Intern Med 165:1643–1650CrossRefPubMed
6.
Zurück zum Zitat Schirmer U (2007) Pulmonalarterienkatheter in Anästhesie und Intensivmedizin. Anaesthesist 56:273–275CrossRefPubMed Schirmer U (2007) Pulmonalarterienkatheter in Anästhesie und Intensivmedizin. Anaesthesist 56:273–275CrossRefPubMed
7.
Zurück zum Zitat Broscheit J, Greim CA (2006) Ultraschall in der Anästhesie – TEE zur Diagnose und zum kardiovaskulären Monitoring. Anasthesiol Intensivmed Notfallmed Schmerzther 41:750–757CrossRefPubMed Broscheit J, Greim CA (2006) Ultraschall in der Anästhesie – TEE zur Diagnose und zum kardiovaskulären Monitoring. Anasthesiol Intensivmed Notfallmed Schmerzther 41:750–757CrossRefPubMed
8.
Zurück zum Zitat Carl M, Alms A, Braun J et al (2007) Guidelines for intensive care in cardiac surgery patients: haemodynamic monitoring and cardio-circulatory treatment guidelines of the German Society for Thoracic and Cardiovascular Surgery and the German Society of Anaesthesiology and Intensive Care Medicine. Thorac Cardiovasc Surg 55:130–148CrossRefPubMed Carl M, Alms A, Braun J et al (2007) Guidelines for intensive care in cardiac surgery patients: haemodynamic monitoring and cardio-circulatory treatment guidelines of the German Society for Thoracic and Cardiovascular Surgery and the German Society of Anaesthesiology and Intensive Care Medicine. Thorac Cardiovasc Surg 55:130–148CrossRefPubMed
9.
Zurück zum Zitat Connors AF Jr, Speroff T, Dawson NV et al (1996) The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA 276:889–897CrossRefPubMed Connors AF Jr, Speroff T, Dawson NV et al (1996) The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA 276:889–897CrossRefPubMed
10.
Zurück zum Zitat Richard C, Warszawski J, Anguel N et al (2003) Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA 290:2713–2720CrossRefPubMed Richard C, Warszawski J, Anguel N et al (2003) Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA 290:2713–2720CrossRefPubMed
11.
Zurück zum Zitat Harvey S, Harrison DA, Singer M et al (2005) Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet 366:472–477CrossRefPubMed Harvey S, Harrison DA, Singer M et al (2005) Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet 366:472–477CrossRefPubMed
12.
Zurück zum Zitat Wheeler AP, Bernard GR, Thompson BT et al (2006) Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. N Engl J Med 354:2213–2224CrossRefPubMed Wheeler AP, Bernard GR, Thompson BT et al (2006) Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. N Engl J Med 354:2213–2224CrossRefPubMed
13.
Zurück zum Zitat Nilsson LB, Nilsson JC, Skovgaard LT et al (2004) Thermodilution cardiac output – are three injections enough? Acta Anaesthesiol Scand 48:1322–1327CrossRefPubMed Nilsson LB, Nilsson JC, Skovgaard LT et al (2004) Thermodilution cardiac output – are three injections enough? Acta Anaesthesiol Scand 48:1322–1327CrossRefPubMed
14.
Zurück zum Zitat Vender JS (1998) Resolved: A pulmonary artery catheter should be used in the management of the critically ill patient. Pro. J Cardiothorac Vasc Anesth 12:9–12PubMed Vender JS (1998) Resolved: A pulmonary artery catheter should be used in the management of the critically ill patient. Pro. J Cardiothorac Vasc Anesth 12:9–12PubMed
15.
Zurück zum Zitat Munro HM, Wood CE, Taylor BL et al (1994) Continuous invasive cardiac output monitoring – the Baxter/Edwards Critical-Care Swan Ganz IntelliCath and Viligance system. Clin Intensive Care 5:52–55PubMed Munro HM, Wood CE, Taylor BL et al (1994) Continuous invasive cardiac output monitoring – the Baxter/Edwards Critical-Care Swan Ganz IntelliCath and Viligance system. Clin Intensive Care 5:52–55PubMed
16.
Zurück zum Zitat Steltzer H, Krenn CG, Krafft P et al (1997) The pulmonary artery catheter: current status in clinical practice. Acta Anaesthesiol Scand 111:84–87 Steltzer H, Krenn CG, Krafft P et al (1997) The pulmonary artery catheter: current status in clinical practice. Acta Anaesthesiol Scand 111:84–87
17.
Zurück zum Zitat Monchi M, Thebert D, Cariou D et al (1998) Clinical evaluation of the Abbott Qvue-OptiQ continuous cardiac output system in critically ill medical patients. J Crit Care 13:91–95CrossRefPubMed Monchi M, Thebert D, Cariou D et al (1998) Clinical evaluation of the Abbott Qvue-OptiQ continuous cardiac output system in critically ill medical patients. J Crit Care 13:91–95CrossRefPubMed
18.
Zurück zum Zitat D’Ancona G, Parrinello M, Santise G et al (2009) Intraoperative validation of a new system for invasive continuous cardiac output measurement. Intensive Care Med 35:943–947CrossRef D’Ancona G, Parrinello M, Santise G et al (2009) Intraoperative validation of a new system for invasive continuous cardiac output measurement. Intensive Care Med 35:943–947CrossRef
19.
Zurück zum Zitat Thierry S, Thebert D, Brocas E et al (2003) Evaluation of a new invasive continuous cardiac output monitoring system: the truCCOMS system. Intensive Care Med 29:2096–2099CrossRefPubMed Thierry S, Thebert D, Brocas E et al (2003) Evaluation of a new invasive continuous cardiac output monitoring system: the truCCOMS system. Intensive Care Med 29:2096–2099CrossRefPubMed
20.
Zurück zum Zitat Nelson LD (1997) The new pulmonary artery catheters: continuous venous oximetry, right ventricular ejection fraction, and continuous cardiac output. New Horiz 3:251–258 Nelson LD (1997) The new pulmonary artery catheters: continuous venous oximetry, right ventricular ejection fraction, and continuous cardiac output. New Horiz 3:251–258
21.
Zurück zum Zitat Urban P, Scheidegger D, Gabathuler J et al (1987) Thermodilution determination of right ventricular volume and ejection fraction: a comparison with biplane angiography. Crit Care Med 15:652–655CrossRefPubMed Urban P, Scheidegger D, Gabathuler J et al (1987) Thermodilution determination of right ventricular volume and ejection fraction: a comparison with biplane angiography. Crit Care Med 15:652–655CrossRefPubMed
22.
Zurück zum Zitat Hoeper MM, Tongers J, Leppert A et al (2001) Evaluation of right ventricular performance with a right ventricular ejection fraction thermodilution catheter and MRI in patients with pulmonary hypertension. Chest 120:502–507CrossRefPubMed Hoeper MM, Tongers J, Leppert A et al (2001) Evaluation of right ventricular performance with a right ventricular ejection fraction thermodilution catheter and MRI in patients with pulmonary hypertension. Chest 120:502–507CrossRefPubMed
23.
Zurück zum Zitat Hein M, Roehl AB, Baumert JH et al (2009) Continuous right ventricular volumetry by fast response thermodilution during right ventricular ischemia: head-to-head comparison with conductance catheter measurements. Crit Care Med 37:2962–2967CrossRefPubMed Hein M, Roehl AB, Baumert JH et al (2009) Continuous right ventricular volumetry by fast response thermodilution during right ventricular ischemia: head-to-head comparison with conductance catheter measurements. Crit Care Med 37:2962–2967CrossRefPubMed
24.
Zurück zum Zitat Bendjelid K, Schutz N, Suter PM et al (2004) Continuous SvO2 measurements and co-oximetry are not interchangeable immediately after cardiopulmonary bypass. Can J Anaesth 51:610–615CrossRefPubMed Bendjelid K, Schutz N, Suter PM et al (2004) Continuous SvO2 measurements and co-oximetry are not interchangeable immediately after cardiopulmonary bypass. Can J Anaesth 51:610–615CrossRefPubMed
25.
Zurück zum Zitat Groesdonk HV, Shpachenko D, Hanke T et al (2009) Continuous SvO2 monitoring is reliable after on-pump cardiac surgery. IFMBE Proceedings 25/7: 634–637; Springer, Berlin Heidelberg Groesdonk HV, Shpachenko D, Hanke T et al (2009) Continuous SvO2 monitoring is reliable after on-pump cardiac surgery. IFMBE Proceedings 25/7: 634–637; Springer, Berlin Heidelberg
26.
Zurück zum Zitat Baele PL, McMichan JC, Marsh HM et al (1982) Continuous monitoring of mixed venous oxygen saturation in critically ill patients. Anesth Analg 61:513–517CrossRefPubMed Baele PL, McMichan JC, Marsh HM et al (1982) Continuous monitoring of mixed venous oxygen saturation in critically ill patients. Anesth Analg 61:513–517CrossRefPubMed
27.
Zurück zum Zitat Sleutjes BT, Kemps HM, Thijssen EJ et al (2008) The reliability of continuous measurement of mixed venous oxygen saturation during exercise in patients with chronic heart failure. Eur J Appl Physiol 102:493–496CrossRefPubMed Sleutjes BT, Kemps HM, Thijssen EJ et al (2008) The reliability of continuous measurement of mixed venous oxygen saturation during exercise in patients with chronic heart failure. Eur J Appl Physiol 102:493–496CrossRefPubMed
28.
Zurück zum Zitat Gehring H, Duembgen L, Peterlein M et al (2007) Hemoximetry as the „gold standard“? Error assessment based on differences among identical blood gas analyzer devices of five manufacturers. Anesth Analg 105:S24–S30CrossRefPubMed Gehring H, Duembgen L, Peterlein M et al (2007) Hemoximetry as the „gold standard“? Error assessment based on differences among identical blood gas analyzer devices of five manufacturers. Anesth Analg 105:S24–S30CrossRefPubMed
30.
Zurück zum Zitat Rivers EP, Ander DS, Powell D (2001) Central venous oxygen saturation monitoring in the critically ill patient. Curr Opin Crit Care 7:204–211CrossRefPubMed Rivers EP, Ander DS, Powell D (2001) Central venous oxygen saturation monitoring in the critically ill patient. Curr Opin Crit Care 7:204–211CrossRefPubMed
31.
Zurück zum Zitat Sander M, Spies CD, Foer A et al (2007) Agreement of central venous saturation and mixed venous saturation in cardiac surgery patients. Intensive Care Med 33:1719–1725CrossRefPubMed Sander M, Spies CD, Foer A et al (2007) Agreement of central venous saturation and mixed venous saturation in cardiac surgery patients. Intensive Care Med 33:1719–1725CrossRefPubMed
32.
Zurück zum Zitat Varpula M, Karlsson S, Ruokonen E et al (2006) Mixed venous oxygen saturation cannot be estimated by central venous oxygen saturation in septic shock. Intensive Care Med 2006 32:1336–1343CrossRef Varpula M, Karlsson S, Ruokonen E et al (2006) Mixed venous oxygen saturation cannot be estimated by central venous oxygen saturation in septic shock. Intensive Care Med 2006 32:1336–1343CrossRef
33.
Zurück zum Zitat Poeze M, Greve JW, Ramsay G (2005) Meta-analysis of hemodynamic optimization: relationship to methodological quality. Crit Care 9:R771–R779CrossRefPubMed Poeze M, Greve JW, Ramsay G (2005) Meta-analysis of hemodynamic optimization: relationship to methodological quality. Crit Care 9:R771–R779CrossRefPubMed
34.
Zurück zum Zitat Bland RD, Shoemaker WC, Abraham E et al (1985) Hemodynamic and oxygen transport patterns in surviving and nonsurviving postoperative patients. Crit Care Med 13:85–90CrossRefPubMed Bland RD, Shoemaker WC, Abraham E et al (1985) Hemodynamic and oxygen transport patterns in surviving and nonsurviving postoperative patients. Crit Care Med 13:85–90CrossRefPubMed
35.
Zurück zum Zitat Shoemaker WC, Appel PI, Kram HB et al (1988) Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest 94:1176–1186CrossRefPubMed Shoemaker WC, Appel PI, Kram HB et al (1988) Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest 94:1176–1186CrossRefPubMed
36.
Zurück zum Zitat Wilson J, Woods I, Fawcett J et al (1999) Reducing the risk of major surgery: randomized controlled trial of preoptimization of oxygen delivery. BMJ 318:1099–1103PubMed Wilson J, Woods I, Fawcett J et al (1999) Reducing the risk of major surgery: randomized controlled trial of preoptimization of oxygen delivery. BMJ 318:1099–1103PubMed
37.
Zurück zum Zitat Boyd O, Grounds M, Bennett D et al (1993) Preoperative increase of oxygen delivery reduces mortality in high-risk surgical patients. JAMA 270:2699CrossRefPubMed Boyd O, Grounds M, Bennett D et al (1993) Preoperative increase of oxygen delivery reduces mortality in high-risk surgical patients. JAMA 270:2699CrossRefPubMed
38.
Zurück zum Zitat Kern JW, Shoemaker WC (2002) Meta-analysis of hemodynamic optimization in high-risk patients. Crit Care Med 30:1686–1692CrossRefPubMed Kern JW, Shoemaker WC (2002) Meta-analysis of hemodynamic optimization in high-risk patients. Crit Care Med 30:1686–1692CrossRefPubMed
39.
Zurück zum Zitat Sandham JD, Hull RD, Brant RF et al (2003) A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med 348:5–14CrossRefPubMed Sandham JD, Hull RD, Brant RF et al (2003) A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med 348:5–14CrossRefPubMed
40.
Zurück zum Zitat Pölönen P, Ruokonen E, Hippeläinen M et al (2000) A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients. Anesth Analg 90:1052–1059CrossRefPubMed Pölönen P, Ruokonen E, Hippeläinen M et al (2000) A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients. Anesth Analg 90:1052–1059CrossRefPubMed
41.
Zurück zum Zitat Heyland DK, Cook DJ, King D et al (1996) Maximizing oxygen delivery in critically ill patients: a methodologic appraisal of the evidence. Crit Care Med 24:517–524CrossRefPubMed Heyland DK, Cook DJ, King D et al (1996) Maximizing oxygen delivery in critically ill patients: a methodologic appraisal of the evidence. Crit Care Med 24:517–524CrossRefPubMed
42.
Zurück zum Zitat Giglio MT, Marucci M, Testini M et al (2009) Goal-directed haemodynamic therapy and gastrointestinal complications in major surgery: a meta-analysis of randomized controlled trials. Br J Anaesth 103:637–646CrossRefPubMed Giglio MT, Marucci M, Testini M et al (2009) Goal-directed haemodynamic therapy and gastrointestinal complications in major surgery: a meta-analysis of randomized controlled trials. Br J Anaesth 103:637–646CrossRefPubMed
43.
Zurück zum Zitat Brienza N, Giglio MT, Marucci M et al (2009) Does perioperative hemodynamic optimization protect renal function in surgical patients? A meta-analytic study. Crit Care Med 37:2079–2090CrossRefPubMed Brienza N, Giglio MT, Marucci M et al (2009) Does perioperative hemodynamic optimization protect renal function in surgical patients? A meta-analytic study. Crit Care Med 37:2079–2090CrossRefPubMed
44.
Zurück zum Zitat Tuman KJ, McCarthy RJ, Spiess BD et al (1989) Effect of pulmonary artery catheterization on outcome in patients undergoing coronary artery surgery. Anesthesiology 70:199–206CrossRefPubMed Tuman KJ, McCarthy RJ, Spiess BD et al (1989) Effect of pulmonary artery catheterization on outcome in patients undergoing coronary artery surgery. Anesthesiology 70:199–206CrossRefPubMed
45.
Zurück zum Zitat O’Brien MM, Shroyer AL, Moritz TE et al (2004) Relationship between processes of care and coronary bypass operative mortality and morbidity. Med Care 42:59–70CrossRef O’Brien MM, Shroyer AL, Moritz TE et al (2004) Relationship between processes of care and coronary bypass operative mortality and morbidity. Med Care 42:59–70CrossRef
46.
Zurück zum Zitat Gattinoni L, Brazzi L, Pelosi P et al (1995) A trial of goal-oriented hemodynamic therapy in critically ill patients. N Engl J Med 333:1025–1032CrossRefPubMed Gattinoni L, Brazzi L, Pelosi P et al (1995) A trial of goal-oriented hemodynamic therapy in critically ill patients. N Engl J Med 333:1025–1032CrossRefPubMed
47.
Zurück zum Zitat Hayes MA, Timmins AC, Yau EH et al (1994) Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 330:1717–1722CrossRefPubMed Hayes MA, Timmins AC, Yau EH et al (1994) Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 330:1717–1722CrossRefPubMed
48.
Zurück zum Zitat Wheeler AP, Bernard GR, Thompson BT et al (2006) Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med 354:2213–2224CrossRefPubMed Wheeler AP, Bernard GR, Thompson BT et al (2006) Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med 354:2213–2224CrossRefPubMed
49.
Zurück zum Zitat Wiedemann HP, Wheeler AP, Bernard GR et al (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354:2564–2575CrossRefPubMed Wiedemann HP, Wheeler AP, Bernard GR et al (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354:2564–2575CrossRefPubMed
50.
Zurück zum Zitat Binanay C, Califf RM, Hasselblad V et al (2005) Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA 294(13):1625–1633CrossRefPubMed Binanay C, Califf RM, Hasselblad V et al (2005) Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA 294(13):1625–1633CrossRefPubMed
51.
Zurück zum Zitat Friese RS, Shafi S, Gentilello LM (2006) Pulmonary artery catheter use is associated with reduced mortality in severely injured patients: a National Trauma Data Bank analysis of 53,312 patients. Crit Care Med 34:1597–1601CrossRefPubMed Friese RS, Shafi S, Gentilello LM (2006) Pulmonary artery catheter use is associated with reduced mortality in severely injured patients: a National Trauma Data Bank analysis of 53,312 patients. Crit Care Med 34:1597–1601CrossRefPubMed
52.
Zurück zum Zitat Chittock DR, Dhingra VK, Ronco JJ et al (2004) Severity of illness and risk of death associated with pulmonary artery catheter use. Crit Care Med 32:911–915CrossRefPubMed Chittock DR, Dhingra VK, Ronco JJ et al (2004) Severity of illness and risk of death associated with pulmonary artery catheter use. Crit Care Med 32:911–915CrossRefPubMed
53.
Zurück zum Zitat Bossert T, Gummert JF, Bittner HB et al (2006) Swan-Ganz catheter-induced severe complications in cardiac surgery: right ventricular perforation, knotting, and rupture of a pulmonary artery. J Card Surg 21:292–295CrossRefPubMed Bossert T, Gummert JF, Bittner HB et al (2006) Swan-Ganz catheter-induced severe complications in cardiac surgery: right ventricular perforation, knotting, and rupture of a pulmonary artery. J Card Surg 21:292–295CrossRefPubMed
54.
Zurück zum Zitat Scheer B, Perel A, Pfeiffer UJ (2002) Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit Care 6(3):199–204CrossRefPubMed Scheer B, Perel A, Pfeiffer UJ (2002) Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit Care 6(3):199–204CrossRefPubMed
55.
Zurück zum Zitat Piercy M, Mcnicol L, Dinh DT et al (2009) Major complications related to the use of transesophageal echocardiography in cardiac surgery. J Cardiothorac Vasc Anesth 23:62–65CrossRefPubMed Piercy M, Mcnicol L, Dinh DT et al (2009) Major complications related to the use of transesophageal echocardiography in cardiac surgery. J Cardiothorac Vasc Anesth 23:62–65CrossRefPubMed
56.
Zurück zum Zitat Zwissler B (2000) Akutes Rechtsherzversagen. Aetiologie – Pathophysiologie – Diagnose – Therapie. Anaesthesist 49:788–808CrossRefPubMed Zwissler B (2000) Akutes Rechtsherzversagen. Aetiologie – Pathophysiologie – Diagnose – Therapie. Anaesthesist 49:788–808CrossRefPubMed
57.
Zurück zum Zitat Magder S (2006) Central venous pressure: a useful but not so simple measurement. Crit Care Med 34:2224–2227CrossRefPubMed Magder S (2006) Central venous pressure: a useful but not so simple measurement. Crit Care Med 34:2224–2227CrossRefPubMed
58.
Zurück zum Zitat Xu D, Olivier NB, Mukkamala R (2009) Continuous cardiac output and left atrial pressure monitoring by long time interval analysis of the pulmonary artery pressure waveform: proof of concept in dogs. J Appl Physiol 106:651–661CrossRefPubMed Xu D, Olivier NB, Mukkamala R (2009) Continuous cardiac output and left atrial pressure monitoring by long time interval analysis of the pulmonary artery pressure waveform: proof of concept in dogs. J Appl Physiol 106:651–661CrossRefPubMed
Metadaten
Titel
Pulmonalarterienkatheter in der Anästhesiologie und operativen Intensivmedizin
Eine Bestandsaufnahme
verfasst von
Prof. Dr. M. Heringlake
H. Heinze
Publikationsdatum
01.06.2010
Verlag
Springer-Verlag
Erschienen in
Intensivmedizin und Notfallmedizin / Ausgabe 5/2010
Print ISSN: 0175-3851
Elektronische ISSN: 1435-1420
DOI
https://doi.org/10.1007/s00390-009-0148-7

Weitere Artikel der Ausgabe 5/2010

Intensivmedizin und Notfallmedizin 5/2010 Zur Ausgabe

Innovationen in der Intensivmedizin

Messung des intraabdominellen Drucks

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Hodgkin Lymphom: BrECADD-Regime übertrifft die Erwartungen

05.06.2024 ASCO 2024 Kongressbericht

Das Kombinationsregime BrECADD mit Brentuximab vedotin ermöglichte in der Studie HD21 beim fortgeschrittenen klassischen Hodgkin-Lymphom eine unerwartet hohe progressionsfreie Überlebensrate von 94,3% nach vier Jahren. Gleichzeitig war das Regime besser tolerabel als der bisherige Standard eBEACOPP.

Antikörper-Drug-Konjugat verdoppelt PFS bei Multiplem Myelom

05.06.2024 ASCO 2024 Nachrichten

Zwei Phase-3-Studien deuten auf erhebliche Vorteile des Antikörper-Wirkstoff-Konjugats Belantamab-Mafodotin bei vorbehandelten Personen mit Multiplem Myelom: Im Vergleich mit einer Standard-Tripeltherapie wurde das progressionsfreie Überleben teilweise mehr als verdoppelt.

Neuer TKI gegen CML: Höhere Wirksamkeit, seltener Nebenwirkungen

05.06.2024 Chronische myeloische Leukämie Nachrichten

Der Tyrosinkinasehemmer (TKI) Asciminib ist älteren Vertretern dieser Gruppe bei CML offenbar überlegen: Personen mit frisch diagnostizierter CML entwickelten damit in einer Phase-3-Studie häufiger eine gut molekulare Response, aber seltener ernste Nebenwirkungen.

Hereditäres Angioödem: Tablette könnte Akuttherapie erleichtern

05.06.2024 Hereditäres Angioödem Nachrichten

Medikamente zur Bedarfstherapie bei hereditärem Angioödem sind bisher nur als Injektionen und Infusionen verfügbar. Der Arzneistoff Sebetralstat kann oral verabreicht werden und liefert vielversprechende Daten.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.