Titre
Video fluoroscopy for pulmonary artery catheter insertion in high-risk situation of knotting or misplacement.
Type
étude de cas
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
European review for medical and pharmacological sciences
Auteur(s)
Ltaief, Z.
Auteure/Auteur
Qanadli, S.D.
Auteure/Auteur
Eckert, P.
Auteure/Auteur
Ben-Hamouda, N.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
2284-0729
Statut éditorial
Publié
Date de publication
2020-11
Volume
24
Numéro
22
Première page
11773
Dernière page/numéro d’article
11775
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Pulmonary artery catheter (PAC) insertion in patients with severe pulmonary hypertension, right heart dilation and failure, is very challenging. Misplacement and knotting are rare but could be serious complications leading to a delay of the monitoring and sometimes an emergent not expected intervention. Here we report a case of a patient admitted to Intensive Care Unit (ICU) with an acute hypoxemic respiratory failure. She had a history of chronic respiratory failure with pulmonary hypertension and right heart failure. We decided to monitor her cardiac output and pulmonary pressure with a PAC. Repeated attempts to reach the pulmonary artery (PA) were unsuccessful and the PAC was knotted and blocked at the distal tip of the introducer. Under fluoroscopy the knot was released by radiologist. Few days later, a monitoring of PA pressure was needed to guide a PA vasodilator treatment. Under fluoroscopic guidance with the supervision of radiologist, the catheter was successfully placed in the PA at the first attempt. Despite some limitations (patient displacement and radiation), this technique is more accurate than waveform guidance. We suggest in specific situations (low cardiac output, severe pulmonary hypertension, and severe tricuspid regurgitation) to consider first fluoroscopy.
PID Serval
serval:BIB_AB27E4B9115F
PMID
Date de création
2020-12-05T06:41:23.174Z
Date de création dans IRIS
2025-05-21T04:21:27Z