Pulmonary Artery Catheters (PAC) is a diagnostic and haemodynamic monitoring tool but not a therapeutic intervention. Our review concluded that use of a PAC did not alter the mortality, general ICU or hospital LOS, or cost for adult patients in intensive care.

The quality of evidence was high for mortality and LOS but low for cost analysis.

Efficacy studies are needed to determine if there are optimal PAC-guided management protocols, which when applied to specific patient groups in ICUs could result in benefits such as shock reversal, improved organ function and less vasopressor use.

Newer, less-invasive hemodynamic monitoring tools need to be validated against PAC prior to clinical use in critically ill patients.

We included 13 studies (5,686 patients).

We judged blinding of participants and personnel and blinding of outcome assessment to be at high risk in about 50% of the included studies and at low risk in 25% to 30% of the studies.

Regardless of the high risk of performance bias these studies were included based on the low weight the studies had in the meta-analysis.

We rated 75% of the studies as low risk for selection, attrition and reporting bias.

All 13 studies reported some type of hospital mortality (28-day, 30-day, 60-day or ICU mortality).

We considered studies of high-risk surgery patients (8 studies) and general intensive care patients (5 studies) separately as subgroups for meta-analysis.

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