Pulmonary artery pressure monitoring in acute burn management

Perforation of the pulmonary artery requiring pneumonectomy after the use of a flow-directed (Swan-Ganz) catheter

“…Although five previous cases of pulmonary artery perforation have been reported (Chun and Ellestad, 1971;Lapin et al, 1972;German et al, 1973;Golden et al, 1973;Page et al, 1974), the factors involved in these perforations by balloontipped catheters are unclear. Several predisposing factors have been emphasised; pulmonary hypertension (German et al, 1973), an excessively peripheral location of the catheter (Chun and Ellestad, 1971), a large loop of catheter in the right atrium or right ventricle which may allow the tip to perforate the pulmonary wall secondary to catheter motion (Chun and Ellestad, 1971), and anticoagulation (Golden et al, 1973).…”

“…Several predisposing factors have been emphasised; pulmonary hypertension (German et al, 1973), an excessively peripheral location of the catheter (Chun and Ellestad, 1971), a large loop of catheter in the right atrium or right ventricle which may allow the tip to perforate the pulmonary wall secondary to catheter motion (Chun and Ellestad, 1971), and anticoagulation (Golden et al, 1973).…”

“…The common complications associated with their insertion are usually not severe and have not been associated with lethal consequences (Foote et al, 1974;Katz et al, 1977). Major complications have been described, among which are five cases of pulmonary artery perforation, two of them fatal (Chun and Ellestad, 1971;Lapin and Murray, 1972;German et al, 1973;Golden et al, 1973;Page et al, 1974).…”