scholarly journals Diagnosis and Rescue of a Kinked Pulmonary Artery Catheter

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Nicolas J. Mouawad ◽  
Erica J. Stein ◽  
Kenneth R. Moran ◽  
Michael R. Go ◽  
Thomas J. Papadimos
Keyword(s):  
Pulmonary Artery ◽  
Hemodynamic Monitoring ◽  
Monitoring Tool ◽  
Less Invasive ◽  
Invasive Hemodynamic Monitoring ◽  
Cannulation Site ◽  
Pulmonary Artery Catheters ◽  
Catheter Tip ◽  
Successful Removal ◽  
Surgical Operations

Invasive hemodynamic monitoring with a pulmonary catheter has been relatively routine in cardiovascular and complex surgical operations as well as in the management of critical illnesses. However, due to multiple potential complications and its invasive nature, its use has decreased over the years and less invasive methods such as transesophageal echocardiography and hemodynamic sensors have gained widespread favor. Unlike these less invasive forms of hemodynamic monitoring, pulmonary artery catheters require an advanced understanding of cardiopulmonary physiology, anatomy, and the potential for complications in order to properly place, manage, and interpret the device. We describe a case wherein significant resistance was encountered during multiple unsuccessful attempts at removing a patient’s catheter secondary to kinking and twisting of the catheter tip. These attempts to remove the catheter serve to demonstrate potential rescue options for such a situation. Ultimately, successful removal of the catheter was accomplished by simultaneous catheter retraction and sheath advancement while gently pulling both objects from the cannulation site. In addition to being skilled in catheter placement, it is imperative that providers comprehend the risks and complications of this invasive monitoring tool.

scholarly journals Invasive, minimally invasive and non-invasive hemodynamic monitoring in perioperative medicine

2020 ◽  
Vol 12 (1) ◽  
pp. 7-19
Author(s):  
Guerrero Gutiérrez Manuel Alberto ◽  
Pérez Nieto Orlando Rubén ◽  
Eder Iván Zamarrón López ◽  
Jesús Salvador Sánchez Díaz ◽  
Escarramán Martínez Diego ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pulmonary Artery ◽  
Minimally Invasive ◽  
Hemodynamic Monitoring ◽  
Perioperative Period ◽  
Invasive Monitoring ◽  
Less Invasive ◽  
Non Invasive ◽  
Fundamental Part ◽  
Invasive Hemodynamic Monitoring

The hemodynamic monitoring is a fundamental part of the patient in the perioperative period, during the last decade the monitoring at the patient's bedside has grown at giant steps, from the emergency area, operating room, to the Intensive Care area. One of its most important advances is the decrease in the use of pulmonary artery catheter, which is being replaced by ultrasound and less invasive monitoring techniques, in this article we will review from the beginning of the monitoring to the most used less invasive monitors currently.

Hemodynamic Monitoring in the ICU

2014 ◽  
Author(s):  
Sunny Lim ◽  
Andrew M Luks
Keyword(s):  
Pulmonary Artery ◽  
Hemodynamic Monitoring ◽  
Point Of Care ◽  
Pulmonary Artery Occlusion Pressure ◽  
Central Venous Oxygen Saturation ◽  
Artery Occlusion ◽  
Right Atrial ◽  
Pressure Waveform ◽  
Occlusion Pressure ◽  
Less Invasive

This review examines the most commonly used hemodynamic monitoring devices in the intensive care unit. After a brief review of some important issues in hemodynamic monitoring, a variety of monitoring systems are considered, including arterial catheters, pulmonary artery catheters (PACs), less invasive hemodynamic monitors, central venous oxygen saturation (ScvO2) monitors, and point-of-care (POC) echocardiography. For each system, the basic operating principles, indications and limitations of use, complications, key issues in data interpretation, and evidence regarding utility in patient care are reviewed. Figures depict the distinction between correlation and agreement, a representative Bland-Altman plot, a square wave test, PAC waveforms, principles of pulmonary artery occlusion pressure measurement, measuring pulmonary artery occlusion pressure at end-exhalation, right atrial and ventricular pressure waveform, pulmonary artery pressure waveform, potential pulmonary artery occlusion waveforms, west zones of the lung and the pulmonary artery occlusion pressure measurements, and POC echocardiography. Tables outline landmarks during insertion of the PAC from the internal jugular and subclavian vein insertion sites; indications, contraindications, and complications of PAC insertion; a comparison of less invasive hemodynamic monitors; reasons for decreased mixed or ScvO2; and indications and contraindications for transesophageal echocardiography. This review contains 12 highly rendered figures, 7 tables, and 95 references.

Continuous, Less Invasive, Hemodynamic Monitoring in Intensive Care After Cardiac Surgery

1998 ◽  
Vol 46 (04) ◽  
pp. 242-249 ◽  
Author(s):  
O. Gödje ◽  
K. Höke ◽  
P. Lamm ◽  
C. Schmitz ◽  
C. Thiel ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Hemodynamic Monitoring ◽  
Less Invasive ◽  
Invasive Hemodynamic Monitoring

Less invasive hemodynamic monitoring in critically ill patients

2016 ◽  
Vol 42 (9) ◽  
pp. 1350-1359 ◽  
Author(s):  
Jean-Louis Teboul ◽  
Bernd Saugel ◽  
Maurizio Cecconi ◽  
Daniel De Backer ◽  
Christoph K. Hofer ◽  
...  
Keyword(s):  
Critically Ill ◽  
Hemodynamic Monitoring ◽  
Critically Ill Patients ◽  
Less Invasive ◽  
Invasive Hemodynamic Monitoring

Hemodynamic Monitoring in the ICU

2014 ◽  
pp. 403-409
Author(s):  
Patricia A. Kritek
Keyword(s):  
Pulmonary Artery ◽  
Hemodynamic Monitoring ◽  
Venous Pressure ◽  
Venous Catheter ◽  
Arterial Line ◽  
Central Venous ◽  
Great Debate ◽  
Pulmonary Artery Catheters ◽  
Life Threatening ◽  
Critical Patients

Hemodynamic monitoring is a central part of the care of many patients in the intensive care unit (ICU). The most invasive form of hemodynamic monitoring is a pulmonary artery catheter (PA catheter), often referred to as a Swan-Ganz catheter after its coinventors Jeremy Swan and William Ganz. More commonly, a patient's central venous pressure and arterial pressure will be monitored via a central venous catheter and an arterial line, respectively. There are limited data that use of hemodynamic monitoring impacts mortality of critical patients. In fact, the use of PA catheters has been a subject of great debate for nearly four decades. That being said, many intensivists believe the data from these devices contribute to better management of patients in the ICU and can have a role in diagnosing certain life-threatening conditions. The majority of this chapter focuses on the use of pulmonary artery catheters including their potential roles in the ICU, the placement of these devices, the measurements they provide, and the subsequent interpretation of these data.

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