This is the podcast, ICU rounds.

My name is Dr. Jeffrey Guy.

I'm an associate professor of surgery and director at the Burns Center at the Vanderbilt University School of Medicine in Nashville, Tennessee.

Welcome back to the podcast.

We're going to pick up on a discussion on pulmonary artery catheters. I was looking back at previous podcasts, and we did some podcasts on pulmonary catheters about two years ago, but I want to focus on one number that is looked at probably more than any other number on a PA catheter or a swan,

and that's the wedge.

And the wedge, for a lot of reasons, I think, is misunderstood.

It is misinterpreted.

People make way too many decisions based on that one number,

then perhaps they should.

Last week we talked about what I called my favorite number on a PA catheter, and that's

the SVO2.

And to me, that's a number that has a lot of integrity.

I can rely on it a lot.

And it's able to predict how my treatment of shock is going.

And when we think about shock, one thing that I think people misunderstand often

is that they think shock represents a patient who has a low blood pressure. Most of what intensive

care units exist for nowadays, and it doesn't really matter what kind of intensive care unit.

I run a burn intensive care unit, it could be a trauma intensive care unit, a neurointensive

care unit, a cardiac surgical ICU.

But most of what ICUs do is to avoid the development of and to treat shock.

And shock is defined when oxygen delivery is not adequate to meet cellular demand.

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