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Francisco Chacón-Lozsán: Pulmonary Artery Catheter in Cardiogenic Shock From Obsolete Device to Modern Decision Tool
Francisco Chacón-Lozsán/LinkedIn
Apr 23, 2026, 02:17

Francisco Chacón-Lozsán: Pulmonary Artery Catheter in Cardiogenic Shock From Obsolete Device to Modern Decision Tool

Francisco Chacón-Lozsán, Fellow at World Extreme Medicine, Member of European Society of Intensive Care Medicine (ESICM) and American College of Cardiology, shared a post on LinkedIn:

”Pulmonary artery catheter: dead… or misunderstood?

For years, we were told:

  • ‘No mortality benefit’
  • ‘Too invasive’
  • Old technology’

But in cardiogenic shock… the story is changing.

New meta-analysis. Approximately 790,000 patients.

The signal is clear:

  • Mortality decreased(OR 0.70)
  • Hazard of death decreased by 32%
  • Use of MCS increased(OR 2.76)
  • Sepsis risk increased(OR 1.83)

So what’s really happening?

This is not about the catheter.

It’s about what you do with the data.

PAC as a ‘therapeutic enabler’

PAC doesn’t treat patients.

It enables:

  • Phenotype-driven shock classification
  • Precise preload / afterload optimization
  • Early identification of RV failure
  • Timely escalation to MCS

In other words:

It transforms guesswork into strategy

Why previous trials failed

Pacman. Escape.

They showed no benefit.

But the problem wasn’t the catheter…

It was the absence of:

  • Structured protocols
  • Shock teams
  • Clear hemodynamic targets

Modern cardiogenic shock is different

Today we have:

  • Shock teams
  • SCAI staging
  • Protocol-driven escalation
  • Advanced MCS (Impella, ECMO)

In this context, PAC becomes powerful.

The trade-off

Let’s be honest:

  • Increased infection risk

OR approximately 1.8 for sepsis

So:

  • Use it selectively
  • Use it early
  • Remove it as soon as possible

Key takeaway

PAC is not obsolete.

It was misused.

And now, in the right hands:

It may be one of the most important tools in cardiogenic shock.”

Francisco Chacón-Lozsán: Pulmonary Artery Catheter in Cardiogenic Shock From Obsolete Device to Modern Decision Tool

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