Vol. 55, No. 12, December 2005 558 Short Report Retrospective Review of the use of Swan Ganz Catheters in our Intensive Care Unit (ICU): a Short Report Shahla Siddiqui Department of Anaesthesia and Critical Care, The Aga Khan University Hospital, Karachi. Abstract The widespread and often 'misuse' of the Swan Ganz (SG) or Pulmonary artery catheter has often been seen in intensive care patients. The objective of this preliminary review was to observe the trends and possibly formulate an association with outcome of the use of SG catheters as well as to determine the frequency of use and possible complications. The chart review of ten patients was carried out for the months of January and February 2004 in a retrospective manner. The incidence of SG catheter insertion was 12% per month on average. Nine out of 10 patients received the SG catheters for 'fluid management'; and 1 for 'haemody- namic instability'. Eight out of 10 patients expired and aver- age length of stay was 9 days. There were no complications recorded. The cause of death in all patients was 'severe sep- sis'. The overwhelming majority of patients who received these catheters expired at the end of their stay. Introduction Existing randomized controlled trials on SG catheter-guided strategies reveal a modest risk reduction that does reach statistical significance. Risk reduction appears to be greatest in surgical series. 1 The procedure commonly includes insertion of a flexible, balloon-tipped catheter into the pulmonary artery for haemodynamic mon- itoring of the critically ill patient. 2 This is primarily insert- ed for patients with systemic shock requiring haemodynam- ic support. However the efficacy of data collected from its use is debatable. 3,4 The safety of pulmonary artery catheter- ization has been questioned. 5 Most clinicians believe that PAC use is beneficial in guiding therapy and may improve outcome. Despite these beliefs and hundreds of published articles related to SG catheters, appropriate use and impact on outcome remain unclear. 6 Direct pressure measurements are obtained in the respective cardiac chambers and pul- monary artery. An indirect measurement of left atrial filling pressure is obtained when the catheter is "wedged". In addi- tion, other haemodynamic parameters may be easily meas- ured, such as the cardiac output, systemic vascular resist- ance (SVR), mixed venous oxygen saturation, and intrapul- monary shunt fraction. 7 Many studies have been done in the West looking at similar parameters as ours in their setting. 8 However, given the high cost of intensive care and monitor- ing and doubtful improvement in outcome, we wished to embark on a retrospective review to observe, the frequency of SG catheter use, and indications for SG catheter use in our ICU. Correlation with length of stay (days), outcome of the patient and complications, if any were also noted. Methods and Results A retrospective chart review was carried out on all patients who had a SG catheter placed whilst in the ICU from January 1 st - February 28 th 2005. Inclusion criteria was all adults (above the age of 18) receiving SG catheters. Exclusion criteria were all paediatric patients and post car- diopulmonary resuscitation (CPR) patients. The setting was a 12 bedded multidisciplinary intensive care unit of a tertiary