Beta-Blocker Therapy for Heart Failure: The Evidence Is In, Now the Work Begins

Article Abstract:

All patients with heart failure should take a beta blocker as long as they have no reason not to. In 2000, a study on extended-release metoprolol showed that the drug reduced mortality rates, decreased the amount of time spent in a hospital, and improved the patients' quality of life. The treatment appears to be cost effective and may even save money in the long run. Some patients may experience a brief deterioration in the quality of life shortly after beginning the drugs and many are concerned about side effects. But the long-term benefits may outweigh short-term side effects.

Editorial, Drug therapy, Heart failure, Adrenergic beta blockers, Adrenergic beta-antagonists

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The effectiveness of right heart catheterization in the initial care of critically ill patients

Article Abstract:

Cardiac catheterization using a Swan-Ganz catheter may actually be detrimental to most critically ill patients. Cardiac catheterization is often used in these patients to monitor heart function. Researchers studied the use of cardiac catheterization in 5,735 critically ill patients between 1989 and 1994. Patients who were catheterized had a slightly higher 30-day mortality rate. They also used more resources and stayed in the ICU longer. This outcome remained even when the data were adjusted for other risk factors for mortality.

Patient outcomes, Mortality, Medical care, Medical care utilization, Critically ill

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Impact of the pulmonary artery catheter in critically ill patients: Meta-analysis of randomized clinical trials

Article Abstract:

A meta-analysis of thirteen published clinical trials was performed to estimate the impact of the pulmonary artery catheter (PAC) device in critically ill patients. Use of the PAC was found to neither increase overall mortality or days in hospital nor confer any benefit, indicating the lack of a clear strategy leading to improved survival with the PAC.

United States, Care and treatment, Diagnosis, Terminally ill persons, Terminally ill, Lung diseases

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