Wiegers, Susan E. MD, FACC, FASE
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Finally, we are left with the question of whether it is clinically necessary to follow PCWP invasively or noninvasively once the hemodynamics of an individual patient have been clarified. The repeated calls from the intensive care unit to “assess volume status” have, at least at our institution, in some cases replaced careful clinical assessment by physical examination and review of daily weights, I's and O's, A-a gradient, and so forth. The ESCAPE trial is frequently quoted as the reason to avoid Swan's for ongoing PCWP measurement in patients hospitalized with congestive heart failure.19 A simple noninvasive measurement, such as E/e', would be an attractive alternative. However, there is no evidence that repeated noninvasive assessment will fare any better compared with carefully applied clinical parameters in the care of patients with heart failure.
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Artigo citado
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Viva as novas tecnologias. Pequenos aparelhos, portáteis, instantâneos e telas sensíveis ao toque.
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Elas não vieram para SUBSTITUIR o exame físico detalhado. E têm que provar que servem para alguma coisa.
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