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Scott W. Sharkey, MD
Minneapolis Heart Institute Shakopee, Minn

JAMA. 1997;277(2):111.

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

To the Editor.

—The study by Dr Connors and colleagues¹ has reignited the controversy surrounding the use of the PA catheter in critically ill patients. I do not argue with the results of this well-conducted study, but I wonder why the authors have restricted their focus to the procedure of RHC. Would the results be similar if the authors had tested other procedures commonly performed in the critically ill such as central venous catheterization, intubation and mechanical ventilation, and catheterization of the urinary bladder? Perhaps it is the insertion of a central venous catheter (not the RHC itself) that is associated with increased mortality.

The 30-day survival curves shown in Figure 2¹ are of interest. The curves begin to diverge at hospital day 5 and diverge even further between days 5 and 30. Do the authors propose that RHC on day 1 is somehow responsible for this progressive difference in survival? . . . [Full Text PDF of this Article]

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