Saturday, December 21, 2013

Q: You are trying to float Pulmonary artery catheter (PAC) in a 64 year old patient with severe right ventricular (RV) enlargement. Despite various attempts, catheter continue to curl in RV. What one trick can help you to get PAC pass from RV into Pulmonary artery (PA)?

Answer: When Right side of the heart is dilated or have high pressures, it is hard to place air-filled balloon at proper position.

Filling the balloon with 1 mL of sterile saline and placing the patient in a more upright position allows gravity to cause the PAC to pass into PA. Once the catheter is in position, aspirate the saline and replace it with air to ensure reproducible Wedge tracings.

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