Pulmonary artery catheter

Whitener, Stephanie; Konoske, Ryan; Mark, Jonathan B.

doi:10.1016/j.bpa.2014.08.003

Cited by 22 publications

(18 citation statements)

References 20 publications

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“…A malpositioned PAC tip within the right ventricle increases the risk for ventricular arrhythmias and cardiac perforation. 11,15,16 Other complications related to PAC insertion that may be seen on chest radiographs include pneumothorax, haematoma and catheter migration. 16…”

Section: Tracheal and Oesophageal Tubes And Linesmentioning

confidence: 99%

Chest radiographs of cardiac devices (Part 1): Lines, tubes, non-cardiac medical devices and materials

Mathew

Alexander

Patel

et al. 2019

South African Journal of Radiology

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Chest radiographs (CXRs) are the most common imaging investigations undertaken because of their value in evaluating the cardiorespiratory system. They play a vital role in intensive care units for evaluating the critically ill. It is therefore very common for the radiologist to encounter tubes, lines, medical devices and materials on a daily basis. It is important for the interpreting radiologist not only to identify these iatrogenic objects, but also to look for their accurate placement as well as for any complications related to their placement, which may be seen either on the immediate post-procedural CXR or on a follow-up CXR. In this article, we discussed and illustrated the routinely encountered tubes and lines that one may see on a CXR as well as some of their complications. In addition, we also provide a brief overview of other important non-cardiac medical devices and materials that may be seen on CXRs.

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Section: Tracheal and Oesophageal Tubes And Linesmentioning

confidence: 99%

Chest radiographs of cardiac devices (Part 1): Lines, tubes, non-cardiac medical devices and materials

Mathew

Alexander

Patel

et al. 2019

South African Journal of Radiology

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“…The PAC is favored by many cardiac anesthesiologists in high-risk cardiac surgery, but there is controversy due to complications regarding PAC insertion [ 2 , 3 ]. Clinical indications for PAC monitoring are shown in Table 1 [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…PAC may help to assess therapy in the setting of severe cardiac dysfunction from valvular or ischemic etiology. Moreover, the PAC is the only modality that can acquire parameters such as continuous cardiac output and real-time pulmonary artery (PA) venous blood oxygen saturation [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Cephalad misplacement of a pulmonary artery catheter in a patient with a preexisting Hickman catheter

et al. 2021

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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.

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“…However, cardiac surgery alters myocardial compliance and makes CVP/PCWP less accurate [19]. Furthermore, errors in interpretation and management based on this information are not infrequent [20]. This has led many to question the utility of these monitors.…”

Section: Invasive Monitoringmentioning

confidence: 99%

Enhanced Recovery Pathways for Cardiac Surgery

Coleman

Chen

Patel

et al. 2019

Curr Pain Headache Rep

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Purpose of Review Enhanced recovery after surgery (ERAS) has become a widespread topic in perioperative medicine over the past 20 years. The goals of ERAS are to improve patient outcomes and perioperative experience, reduce length of hospital stay, minimize complications, and reduce cost. Interventions and factors before, during, and after surgery all potentially play a role with the cumulative effect being superior quality of patient care. Recent Findings Preoperatively, patient and family education, optimization of nutritional status, and antibiotic prophylaxis all improve outcomes. Recovery is also expedited by the use of multimodal analgesia, regional anesthesia, and opioid reducing approaches. Intraoperatively, the anesthesiologist can have an impact by using less-invasive monitors appropriately to guide fluid and hemodynamic management as well as maintaining normothermia. Postoperatively, early enteral feeding, mobilization, and removal of invasive lines support patient recovery. Implementation of ERAS protocol in cardiac surgery faces challenges by some unique perioperative perspectives in cardiac surgery, such as systemic anticoagulation, use of cardiopulmonary bypass, significantly more hemodynamic variations, larger volume replacement, postoperative intubation and mechanical ventilation and associated sedation, and potentially significantly more coexisting morbidities than other surgical procedures. Summary ERAS in cardiac surgery may benefit patients more related to its high risk and high cost nature. This manuscript specifically reviews the unique aspects of enhanced recovery in cardiac surgery.

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Pulmonary artery catheter

Cited by 22 publications

References 20 publications

Chest radiographs of cardiac devices (Part 1): Lines, tubes, non-cardiac medical devices and materials

Chest radiographs of cardiac devices (Part 1): Lines, tubes, non-cardiac medical devices and materials

Cephalad misplacement of a pulmonary artery catheter in a patient with a preexisting Hickman catheter

Enhanced Recovery Pathways for Cardiac Surgery

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