Pulmonary Artery Pressure Monitoring

2006 ◽  
Vol 17 (3) ◽  
pp. 286-305
Author(s):  
Elizabeth J. Bridges

The integration of data from a pulmonary artery catheter when used as part of a goal-directed plan of care may benefit certain groups of critically ill patients. Integral to the successful use of the pulmonary artery catheter is to accurately obtain and interpret invasive pressure monitoring data. This article addresses commonly asked clinical questions and considerations for decision making under complex care conditions, such as obtaining hemodynamic measurements when the patient is prone or has marked respiratory pressure variations or increased intraabdominal pressure. Recommendations to optimize the invasive pressure monitoring system are presented. Finally, functional hemodynamic indices, which are more sensitive and specific indices than static indices (pulmonary artery and right artrial pressure) of the ability to respond to a fluid bolus, will be introduced.

Author(s):  
Carl Waldmann ◽  
Neil Soni ◽  
Andrew Rhodes

ECG monitoring 98Arterial pressure monitoring 102Insertion of central venous catheters 104Common problems with central venous access 106Pulmonary artery catheter: indications and use 108Pulmonary artery catheter: insertion 110Echocardiography 112Clinical application of echocardiography in the ICU 116Doppler 118Pulse pressure algorithms ...


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hoon Choi ◽  
Joon Pyo Jeon ◽  
Jaewon Huh ◽  
Youme Kim ◽  
Wonjung Hwang

Abstract Background Pulmonary artery catheter insertion is a routine practice in high-risk patients undergoing cardiac surgery. However, pulmonary artery catheter insertion is associated with numerous complications that can be devastating to the patient. Incorrect placement is an overlooked complication with few case reports to date. Case presentation An 18-year-old male patient underwent elective mitral valve replacement due to severe mitral valve regurgitation. The patient had a history of synovial sarcoma, and Hickman catheter had been inserted in the right internal jugular vein for systemic chemotherapy. We made multiple attempts to position the pulmonary artery catheter in the correct position but failed. A chest radiography revealed that the pulmonary artery catheter was bent and pointed in the cephalad direction. Removal of the pulmonary artery catheter was successful, and the patient was discharged 10 days after the surgery without complications. Conclusions To prevent misplacement of the PAC, clinicians should be aware of multiple risk factors in difficult PAC placement, and be prepared to utilize adjunctive methods, such as TEE and fluoroscopy.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Akiko Tomita ◽  
Shoko Takada ◽  
Tomoko Fujimoto ◽  
Mitsuo Iwasaki ◽  
Yukio Hayashi

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