PAC complications reduction

Q: Most of the trauma while inserting a Pulmonary Artery Catheter (PAC) is due to inflation of the balloon during the catheter advancement?

A) True

B) False

Answer: B

Keeping the balloon at the tip of PAC (Swan-Ganz catheter) inflated while advancing the catheter minimizes the complications. Most of the complications during PAC insertion occur due to the direct exposure of the tip to the cardiac tissues. These include arrhythmias, catheter misplacement, perforation, rupture of the heart valve, and/or rupture of the pulmonary artery.  Once inflated, the balloon covers most of the tip and protects it from causing trauma. 

Similarly, keeping the balloon deflated during retrieval (backing off) is advisable.

#procedures

Reference:

1. Narumiya C, Isobe F. [Insertion procedure of the Swan-Ganz catheter]. Kyobu Geka. 2010 Jul;63(8 Suppl):607-11. Japanese. PMID: 20715426. 

2. Bossert T, Gummert JF, Bittner HB, Barten M, Walther T, Falk V, Mohr FW. Swan-Ganz catheter-induced severe complications in cardiac surgery: right ventricular perforation, knotting, and rupture of a pulmonary artery. J Card Surg. 2006 May-Jun;21(3):292-5. doi: 10.1111/j.1540-8191.2006.00235.x. PMID: 16684066.