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Swan-Ganz Catheter in Hemodynamic Monitoring Export

J Anaesth Clin Pharmacol, Vol. 22, No. 4. (2006), pp. 335-345.

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cti diagnostic_tools hemodynamics

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Swan, Ganz and colleagues introduced pulmonary artery catheterization for hemodynamic monitoring into clinical practice in 1970. The pulmonary artery catheter, also known as Swan Ganz catheter, allowed accurate measurement of important cardiovascular physiological variables at the bedside and became increasingly popular as they were used in critically ill patients. Proper use of Swan Ganz catheter discloses a wide range of pertinent cardiovascular data that cannot be predicted from standard clinical signs and symptoms. The present article deals with the physiologic basis for pulmonary artery pressure monitoring, method of catheterization, clinical applications and complications associated with Swan Ganz catheter use. In addition to pressure monitoring the basis of intermittent cardiac output monitoring using Swan Ganz catheter, namely, indicator dilution, thermodilution, Fick's method, and continuous cardiac output monitoring are discussed. The article also describes the monitoring of right ventricle using Swan Ganz catheter equipped with a rapid response thermistor and electrodes for intracardiac ECG recording, and measurement of mixed venous oxygen saturation using Swan Ganz catheter incorporated with fiber-optic bundles. The controversies regarding the use of Swan Ganz catheter, including the evidence for and against is also dealt with.


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