Cessation of Pulmonary Artery Catheter-Induced Endobronchial Hemorrhage Associated with the Use of PEEP

Scuderi, Phillip E.; Prough, Donald S.; Price, John; Comer, Paul B.

doi:10.1213/00000539-198302000-00021

Cited by 29 publications

(4 citation statements)

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“…Systemic anticoagulation should be reversed with Protamine; fresh frozen plasma should be given to counteract the effects of thrombolytic therapy; and platelet inhibition should be reversed by a transfusion of platelets. Other means of controlling the hemorrhage include double lumen endotracheal tube insertion and positive end expiratory pressure ventilation [15].…”

Section: Discussionmentioning

confidence: 99%

Rescue PTCA complicated by pulmonary artery rupture after tPA and abciximab

Chadow

Gaba

Safi

et al. 1999

Cathet. Cardiovasc. Intervent.

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Since the introduction of pulmonary artery catheterization for hemodynamic monitoring, several complications associated with its use have been described. Pulmonary artery rupture is an infrequent complication of flow‐directed pulmonary artery catheters. We report a case of pulmonary artery rupture complicating rescue PTCA in the presence of systemic platelet inhibition with abciximab (Reopro), anticoagulation, and thrombolytic therapy. With the increasing use of these medications in patients undergoing acute coronary interventions, particularly those patients requiring hemodynamic monitoring, this uncommon but potentially fatal complication may be seen more frequently. Cathet. Cardiovasc. Intervent. 46:89–91, 1999. © 1999 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Rescue PTCA complicated by pulmonary artery rupture after tPA and abciximab

Chadow

Gaba

Safi

et al. 1999

Cathet. Cardiovasc. Intervent.

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“…When massive hemoptysis has occurred, however, mechanical ventilation with PEEP [8], transcatheter embolization [9] or thoracotomy and lobectomy [10] should be employed. The pulmonary hemorrhage in the present case was controlled with mechanical ventilatory support with 10cmH20 PEEP, which was already applied for ARDS, and hemoptysis disappeared shortly after BOPA.…”

Section: Discussionmentioning

confidence: 99%

Rupture of pulmonary artery induced by balloon occlusion pulmonary angiography

et al. 1995

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A case of pulmonary artery rupture induced by balloon occlusion pulmonary angiography (BOPA) is reported. A flow-directed pulmonary artery catheter had been inserted for hemodynamic monitoring in a septic shock patient complicated by acute respiratory distress syndrome. To check for pulmonary damage, BOPA was performed immediately after hemodynamic measurement. Just as the hand injection of contrast medium was ending, the patient began to cough and a small amount of hemoptysis was observed. The angiogram showed the extravasation of contrast medium from the distal pulmonary artery to the situation of catheter tip. Pulmonary hemorrhage was controlled with mechanical ventilatory support with 10 cmH2O positive end-expiratory pressure and no specific therapy was required. This complication should be kept in mind and using a power injector to avoid injurious transient high pressure pulse is recommended.

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“…Massive haemorrhage from pulmonary artery rupture has a reported incidence of 0.031-0.25% with a mortality of 25-83%. 15 93 153 Management by reversal of anticoagulation and high levels of PEEP has been successful occasionally, 151 but other therapies have often been used. These include selective endobronchial intubation with differential ventilation and transcatheter embolization.…”

Section: Insertionmentioning

confidence: 99%

Pulmonary artery catheterization in anaesthesia and intensive care

Gómez¹,

Palazzo²

1998

British Journal of Anaesthesia

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Since its introduction nearly 30 yr ago, the pulmonary artery catheter (PAC) has become part of everyday management in cardiology, anaesthesia and intensive care but remains controversial. 12 37 78 136 164 The apparent failure to demonstrate improvements in patient outcome 28 66 68 192 and the risks associated with its use 15 153 have long been criticized. 139 Failure to explore its full use and redundancy of the catheter after initial placement are additional concerns. More worrying is the incorrect interpretation of data 64 82 97 and consequent misdirection of therapy. Others are disturbed by a reliance on measurements rather than on clinical signs. 140 However, many argue that the PAC enhances bedside understanding of cardiorespiratory interactions, complements the interpretation of clinical signs and benefits management of haemodynamic disorders. 47 53 62 65 77 136 157 170 The first part of this article reviews the history, technical aspects and practical uses of pulmonary artery catheterization. The second part evaluates the clinical impact of the PAC on anaesthesia and intensive care medicine.

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Cessation of Pulmonary Artery Catheter-Induced Endobronchial Hemorrhage Associated with the Use of PEEP

Cited by 29 publications

References 0 publications

Rescue PTCA complicated by pulmonary artery rupture after tPA and abciximab

Rescue PTCA complicated by pulmonary artery rupture after tPA and abciximab

Rupture of pulmonary artery induced by balloon occlusion pulmonary angiography

Pulmonary artery catheterization in anaesthesia and intensive care

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