Question
In a patient with massive hemoptysis after a pulmonary artery catheter placement, what is the best initial response?
| A. |
Removal of PA catheter
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| B. |
Endobronchial intubation
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| C. |
Suctioning of the oropharynx
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| D. |
Check hemoglobin using point of care testing
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Show Answer
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Correct Answer � B
Explanation
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Ans. B
Massive hemoptysis temporally related to manipulation of a Swan Ganz (PA) catheter is indicative of pulmonary artery rupture. Endobronchial intubation is an immediate step in unilateral pulmonary artery rupture to protect the good lung.
Pulmonary artery rupture is a very rare complication of swan ganz placement. But it is important to remember that the swan ganz is rarely used today. In the past, records were not always kept and complications were often not reported so the true incidence remains unknown.
The most common complication of the catheter is arrhythmias, pneumothorax, and air embolism.
If rupture of the pulmonary artery occurs, transcatheter closure is the first step. Today various coils and glues are available that can be inserted under fluoroscopy at the bedside. The amplatzer plug has been used with some success and if available should be the first choice
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