Advanced ventricular arrhythmias during bedside pulmonary artery catheterization

Sprung, Charles L.; Pozen, Richard G.; Rozanski, John J.; Pinero, Jose; Eisler, Barry R.; Castellanos, A

doi:10.1016/0002-9343(82)90811-7

Cited by 84 publications

(20 citation statements)

References 14 publications

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“…5 In this study, the severity of hypoxemia, acidosis, anemia, and abnormal serum electrolyte levels was similar in patients with and without arrhythmias (P Ͼ 0.05); indeed, values for these variables were close to normal.…”

Section: Discussionsupporting

confidence: 61%

“…They suggested that certain risk factors might predispose to the development of an arrhythmia, such as myocardial infarction, acidosis, and hypoxemia. 5 Iberti et al 9 subsequently reported a 12.7% (7/56) incidence of severe ventricular arrhythmia in patients in an intensive care unit. The 37% incidence of severe arrhythmia found in this study is consistent with previous reports, despite the exclusion of patients with preexisting cardiac disease.…”

Section: Discussionmentioning

confidence: 98%

“…7,8 Sprung et al 5 found that severe ventricular arrhythmia occurred in 53% of critically ill patients undergoing PA catheterization. They suggested that certain risk factors might predispose to the development of an arrhythmia, such as myocardial infarction, acidosis, and hypoxemia.…”

Section: Discussionmentioning

confidence: 99%

“…Severe ventricular arrhythmia was defined as 3 or more consecutive ventricular premature beats at a rate of Ͼ100 per minute. 5 The observed ECG tracings were classified according to the severest type of arrhythmia that occurred. The time taken to advance the PA catheter from the right ventricle to the wedge position was recorded.…”

Section: Methodsmentioning

confidence: 99%

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Incidence of severe ventricular arrhythmias during pulmonary artery catheterization in liver allograft recipients

Gwak

Kim

et al. 2007

Liver Transpl

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Liver allograft recipients may develop a hyperdynamic circulation and cardiac electrophysiologic abnormalities. The incidence of severe ventricular arrhythmias in liver allograft recipients during pulmonary artery (PA) catheterization was determined. One hundred five liver allograft recipients were studied prospectively; 5 of the patients with preexisting valvular heart disease, ischemic heart disease, or arrhythmias were excluded. Severe ventricular arrhythmia, defined as 3 or more consecutive ventricular premature beats occurring at a rate of Ͼ100 per minute, was observed in 37.0% of the patients during insertion of the catheter and in 25.0% of the patients during removal of the catheter. Two patients developed ventricular tachycardia, and 2 developed ventricular fibrillation; the arrhythmias in these 4 patients did not respond to appropriate pharmacological treatment but resolved promptly after removal of the PA catheter. The catheter transit time from the right ventricle to the pulmonary capillary wedge position was longer in patients with severe ventricular arrhythmia than in those without this arrhythmia (91.6 Ϯ 103. Liver transplantation is commonly associated with the administration of large volumes of fluid and massive hemorrhaging; predisposing factors include abnormalities of blood coagulation, the presence of numerous collateral vessels, and prolonged periods of surgery. Patients with end-stage chronic liver disease have a hyperdynamic circulation, features of which include increased cardiac output, tachycardia, and decreased systemic vascular resistance (SVR). These changes are associated with extensive arteriovenous communications and release of systemic vasodilators, such as glucagon, nitric oxide, ferritin, and vasoactive intestinal polypeptide. 1 Severe pulmonary hypertension or intrapulmonary arteriovenous shunts also occur in such patients. 2 Severe pulmonary hypertension is a contraindication to liver transplantation. Assessments of ventricular function are required throughout this procedure. Accordingly, in most centers, a pulmonary artery (PA) catheter is inserted routinely to evaluate cardiac function. The development of arrhythmias during the insertion of a PA catheter in patients undergoing cardiovascular surgery has been reported 3,4 (Fig. 1). However, the incidence of arrhythmias and hemodynamic changes in relation to the placement of a PA catheter in liver allograft recipients is unknown. Our experience with such patients suggests that the development of an arrhythmia commonly occurs during the insertion and removal of the catheter. The aim of this study was to examine prospectively arrhythmias and hemodynamic changes associated with PA catheterization in liver allograft recipients and to investigate possible factors responsible for these complications. PATIENTS AND METHODSThis study was approved by the local institutional review board on human studies; informed consent was

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Incidence of severe ventricular arrhythmias during pulmonary artery catheterization in liver allograft recipients

Gwak

Kim

et al. 2007

Liver Transpl

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“…Dysrhythmia is variously reported at between 13 and 50% (51,52,23). Although these arrhythmias are common, they are generally transient and few require treatment.…”

Section: Complications Of Invasive Monitoringmentioning

confidence: 99%

Pulmonary artery catheterization — uses and abuses

Puri

Kyff

1986

International Journal of Clinical Monitoring and Computing

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Pulmonary artery (PA) catheterization has been extensively employed in the care of the critically ill and injured patients. As the clinical experience has increased, so has the list of indications and complications. Doubts have arisen as to the appropriateness of PA catheterization and positive contributions to patients care. Consensus can be reached as to the usefulness of PA catheterization in patients with severe shock syndromes, adult respiratory distress syndrome and refractory cardiac failure. Patients who require large doses of vasoactive agents may benefit from assessment of hemodynamics. Patients with minimal disease or easily correctable hypovolemia can be safely managed without PA catheter. Similarly patients with chronic obstructive pulmonary disease and renal failure requiring dialysis rarely need PA catheterization. Since technical, septic and thromboembolic complications can develop in a significant number of patients, cost benefit oriented analysis in various subsets of patients is needed. Diagnostic information derived from PA catheters should be related to the clinical condition and shortcomings and pitfalls of data clearly understood. Various indications and their relevance to patient care is reviewed.

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Risk of Developing Complete Heart Block During Bedside Pulmonary Artery Catheterization in Patients With Left Bundle-Branch Block

Morris

Mulvihill²,

Lew³

1987

Arch Intern Med

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Advanced ventricular arrhythmias during bedside pulmonary artery catheterization

Cited by 84 publications

References 14 publications

Incidence of severe ventricular arrhythmias during pulmonary artery catheterization in liver allograft recipients

Incidence of severe ventricular arrhythmias during pulmonary artery catheterization in liver allograft recipients

Pulmonary artery catheterization — uses and abuses

Risk of Developing Complete Heart Block During Bedside Pulmonary Artery Catheterization in Patients With Left Bundle-Branch Block

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