Managing pulmonary artery catheter-induced pulmonary hemorrhage by bronchial occlusion.
A 76-year-old woman underwent mitral valve repair and coronary artery bypass grafting. Intrabronchial bleeding occurred after inflation of the balloon tip of the pulmonary artery catheter in the wedge position. A Forgaty catheter was introduced into the trachea parallel to the endotracheal tube and advanced under bronchoscopic vision into the intermediate bronchus. Tamponade of the bleeding was achieved by by filling the Forgaty balloon tip with saline. Weaning from extracorporeal circulation was uneventful. On the first postoperative day, the Forgaty catheter was removed and bronchial lavage of the middle and lower lobe was performed without any additional bleeding complication.
Schramm
René
R
Department of Thoracic and Cardiovascular Surgery, University Hospital Homburg/Saar, Homburg/Saar, Germany. reneschramm@live.de
Abugameh
Ahmad
A
Tscholl
Dietmar
D
Schäfers
Hans-Joachim
HJ
D000368:Aged; D021721:Balloon Occlusion / Q000379:methods; D001982:Bronchial Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy / Q000379:methods; D002404:Catheterization / Q000009:adverse effects*; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects* / Q000295:instrumentation; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000379:methods; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D011031:Pneumothorax, Artificial / Q000009:adverse effects / Q000379:methods; D011651:Pulmonary Artery / Q000293:injuries*; D011859:Radiography; D018570:Risk Assessment; D012421:Rupture; D012720:Severity of Illness Index; D016896:Treatment Outcome