Massive hemoptysis and tension pneumothorax following pulmonary artery catheterization.
We report a case of massive hemoptysis and bilateral tension pneumothorax immediately following placement of a fiberoptic pulmonary artery catheter. We postulate air entry into a traumatic communication caused by the catheter, traversing a parenchymal artery, the contiguous airspace and the interstitial space. Dissection of air through the perivascular sheath and into tissue planes of the thorax and abdomen followed. This sequence was rapidly fatal. Tension pneumothorax should be considered if dynamic respiratory system compliance remains poor despite aggressive evacuation of blood from the trachea of a patient with a recently inserted balloon-type catheter.
D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D007442:Intubation, Intratracheal; D015470:Leukemia, Myeloid, Acute / Q000150:complications; D008170:Lung Compliance; D008875:Middle Aged; D011023:Pneumonia, Staphylococcal / Q000150:complications / Q000628:therapy; D011030:Pneumothorax / Q000209:etiology*; D011175:Positive-Pressure Respiration; D011651:Pulmonary Artery