Reasons for a decline in the use of the PAC:
(1) availability of noninvasive methods to measure cardiac output and other physiologic parameters
(2) lack of evidence for any benefit in many patients
(3) concern about the risk for complications (thrombosis, infection, vascular perforation, other)
(4) realization that misinterpreting the data can result in suboptimal management decisions
Placement of a PAC may still have a role in the management of:
(1) right ventricular failure
(2) septic shock with ARDS or with poor response to medical management
(3) acute myocardial infarction with cardiogenic shock
(4) a complex condition that is hard to understand
If a PAC is placed, then it should be used in conjunction with a validated evidence-based protocol that utilizes PAC readings for therapeutic decision-making.
