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Rest in Peace?

Gordon D. Rubenfeld, MD, MSc; Elizabeth McNamara-Aslin, BSN, RN, CCRN; Lewis Rubinson, MD, PhD

JAMA. 2007;298:458-461.

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

In this issue of JAMA, an investigation using a nationally representative administrative database reported a marked decline in the use of pulmonary artery (PA) catheters from 5.66 per 1000 medical admissions in 1993 to 1.99 per 1000 medical admissions in 2004.¹ These significant declines in PA catheter utilization were most prominent for patients with myocardial infarction (81% decrease), but also were significant for surgical patients (63% decrease) and for patients with septicemia (54% decrease).

These national data are consistent with trends at our institution, an academic public hospital and level 1 trauma center with 75 intensive care unit (ICU) beds with a relatively low volume of patients with acute myocardial infarction. For example, from July 2002 to May 2003, the hospital billed patients for 871 PA catheters. Although the ICU census has increased, the use . . . [Full Text of this Article]

Author Affiliations: Division of Pulmonary and Critical Care Medicine (Drs Rubenfeld and Rubinson) and Department of Nursing (Ms McNamara-Aslin), Harborview Medical Center, University of Washington, Seattle. Dr Rubenfeld is now with the Program in Trauma, Critical Care, and Emergency Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

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