Objective: Objective evidence to justify invasive haemodynamics (PA catheter) in defined groups of patients in intensive paediatric care. Design: Prospective observational study. Patients: Two groups of patients were defined: 1. patients with severe refractory shock not responding to „fluid“ resuscitation, 2. patients meeting ARDS criteria. Method: The authors compared the results of assessment at time „0 hours“ after insertion of a PA catheter Arrow 4 and 7 Fr with a monitoring unit Datex AS/3. They investigated in patients with severe refractory shock CI, SVRI, PVRI, DO2, VIO2, O2ER, in patients with ARDS in addition PAP mean, PCWP. Results: In all patients, based on results of haemodynamic monitoring movement of the supply of oxygen consumption improved. No complications were recorded neither as a result of insertion nor as a result of measurements.

        Key words: PA catheter, haemodynamics, ARDS, shock