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Robert A. Fowler, MD; Deborah J. Cook, MD

JAMA. 2003;290:2732-2734.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Long-awaited advances in the treatment of critically ill patients with shock and acute lung injury are evidenced by recent randomized trials of mortality-reducing interventions.^1-5 However, research that strives to change clinical practice is often met with a combination of celebration, skepticism, and controversy. One continuing controversy concerns the utility of the quintessential technology of the intensive care unit (ICU): the pulmonary artery catheter (PAC). The PAC is unique in its multipurpose role. Used for diagnosis, monitoring, and inexorably linked to goal-directed therapy, the PAC has shaped how generations of physicians define and treat critical illness. Indeed, according to a popular critical care textbook, the PAC is "not just important for the specialty of critical care, it is responsible for the specialty of critical care."⁶

Pulmonary artery catheterization was initially performed in cardiac catheterization laboratories to aid in decision making about cardiothoracic surgery.⁷ . . . [Full Text of this Article]

Author Affiliations: Departments of Medicine and Critical Care Medicine, University of Toronto, Toronto, Ontario (Dr Fowler); Departments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, and Consulting Editor, JAMA (Dr Cook).

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