The need to place a pulmonary artery catheter for monitoring a patient with congestive heart failure in the hospital is a subject of debate. Invasive monitoring is indicated in a patient with heart failure who has one or more findings associated with an increased risk of death.
Patients with congestive heart failure who may benefit from invasive monitoring with a pulmonary artery catheter:
(1) severe decompensation
(2) systolic blood pressure < 90 mm Hg
(3) respiratory rate > 30 breaths per minute
(4) serum sodium concentration < 135 mEq/L
(5) echocardiographic evidence of ischemia
(6) renal insufficiency
(7) ratio of pulse pressure to systolic blood pressure < 0.25
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